MEDICARE: MR. GEOFFREY W HOFFA P.A.-C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	2396	AZ
2	363AM0700X	Medical Physician Assistant	2396	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417931890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GEOFFREY W HOFFA P.A.-C.

Provider Business Mailing Address
First Line	:	3120 W CAREFREE HWY
Second Line	:	SUITE 1, PMB# 529
City	:	PHOENIX
State	:	AZ
Zip	:	85086-3201
Country	:	US
Telephone Number	:	480-268-0561
Fax Number	:	480-323-2617

Provider Business Practice Location Address
First Line	:	3120 W CAREFREE HWY
Second Line	:	SUITE 1, PMB# 529
City	:	PHOENIX
State	:	AZ
Zip	:	85086-3201
Country	:	US
Telephone Number	:	480-268-0561
Fax Number	:	480-323-2617

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	03/13/2008

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