MEDICARE: HOFFMAN CHIROPRACTIC

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	111N00000X	Chiropractor	DC18110	CA

General Provider Information

NPI Number	:	1508176785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOFFMAN CHIROPRACTIC

Provider Business Mailing Address
First Line	:	6703 CONVOY CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1010
Country	:	US
Telephone Number	:	858-627-9220
Fax Number	:	858-627-9222

Provider Business Practice Location Address
First Line	:	6703 CONVOY CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1010
Country	:	US
Telephone Number	:	858-627-9220
Fax Number	:	858-627-9222

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KEVIN HOFFMAN
Credential	:	D.C
Telephone Number	:	858-627-9220

Provider Enumeration Date	:	10/20/2010
Last Update Date	:	10/20/2010

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Directions to “HOFFMAN CHIROPRACTIC ” Practice Location

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