Healthcare Provider Details

I. General information

NPI: 1598859654
Provider Name (Legal Business Name): JAMES STANLEY HOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 S FAIRMONT AVE SUITE 135
LODI CA
95240-5100
US

IV. Provider business mailing address

999 S FAIRMONT AVE SUITE 135
LODI CA
95240-5100
US

V. Phone/Fax

Practice location:
  • Phone: 209-366-2060
  • Fax: 209-366-2032
Mailing address:
  • Phone: 209-642-4482
  • Fax: 209-369-4880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG50029
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: