MEDICARE: TAWNYA IRENE HOFFMAN PA-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	363AM0700X	Medical Physician Assistant	PA19295	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00776482	OTHER		RAILROAD MEDICARE

General Provider Information

NPI Number	:	1538351705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAWNYA IRENE HOFFMAN PA-C

Provider Business Mailing Address
First Line	:	10470 OLD PLACERVILLE RD
Second Line	:	SUITE 100
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2539
Country	:	US
Telephone Number	:	800-470-0071
Fax Number	:

Provider Business Practice Location Address
First Line	:	16911 WILLOW GLEN ROAD
Second Line	:
City	:	BROWNSVILLE
State	:	CA
Zip	:	95919-0609
Country	:	US
Telephone Number	:	530-675-0466
Fax Number	:	530-675-0530

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

Provider Enumeration Date	:	08/13/2007
Last Update Date	:	03/07/2023

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