Healthcare Provider Details

I. General information

NPI: 1225008733
Provider Name (Legal Business Name): ELIZABETH MENEELEY HOFMEISTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 CITRACADO PKWY STE 301
ESCONDIDO CA
92029-4113
US

IV. Provider business mailing address

NAVAL MEDICAL CTR
SAN DIEGO CA
92134-5000
US

V. Phone/Fax

Practice location:
  • Phone: 760-746-3937
  • Fax: 760-746-3991
Mailing address:
  • Phone: 619-532-6702
  • Fax: 619-532-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101151068
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD073212L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License NumberG166728
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG166728
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: