Healthcare Provider Details

I. General information

NPI: 1457717217
Provider Name (Legal Business Name): ERIK HOFMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2016
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST ROOM 1060K
LOS ANGELES CA
90033-1029
US

IV. Provider business mailing address

6600 BRUCEVILLE RD
SACRAMENTO CA
95823-4671
US

V. Phone/Fax

Practice location:
  • Phone: 510-604-2835
  • Fax: 323-226-8101
Mailing address:
  • Phone: 510-625-2856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number139971
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: