Healthcare Provider Details

I. General information

NPI: 1982574109
Provider Name (Legal Business Name): MAKAYO HOFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11175 CAMPUS ST
LOMA LINDA CA
92350-1700
US

IV. Provider business mailing address

1360 S FIGUEROA ST APT 319
LOS ANGELES CA
90015-2883
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: