Healthcare Provider Details

I. General information

NPI: 1619345071
Provider Name (Legal Business Name): CHRISTIAN HOFFERT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 09/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 MISSION ST SUITE 111
DALY CITY CA
94014-2063
US

IV. Provider business mailing address

6150 MISSION ST SUITE 111
DALY CITY CA
94014-2063
US

V. Phone/Fax

Practice location:
  • Phone: 650-409-7589
  • Fax:
Mailing address:
  • Phone: 650-409-7589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number15943
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: