Healthcare Provider Details

I. General information

NPI: 1871699702
Provider Name (Legal Business Name): BRENDA HOFFMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 E CANYON RIM RD #103A
ANAHEIM CA
92807-4317
US

IV. Provider business mailing address

6200 E CANYON RIM RD #103A
ANAHEIM CA
92807-4317
US

V. Phone/Fax

Practice location:
  • Phone: 714-974-9317
  • Fax:
Mailing address:
  • Phone: 714-974-9317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG33127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: