Healthcare Provider Details

I. General information

NPI: 1356637946
Provider Name (Legal Business Name): CLIFFORD REES HOFFMAN D.O., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 01/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 E 2ND ST STE 103
BENICIA CA
94510-3324
US

IV. Provider business mailing address

831 E 2ND ST STE 103
BENICIA CA
94510-3324
US

V. Phone/Fax

Practice location:
  • Phone: 707-750-5944
  • Fax: 707-750-5185
Mailing address:
  • Phone: 707-750-5944
  • Fax: 707-750-5185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A13761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: