Healthcare Provider Details

I. General information

NPI: 1760847040
Provider Name (Legal Business Name): VICKI HOFFMAN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2015
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 FERNHOFF RD
OAKLAND CA
94619-3111
US

IV. Provider business mailing address

5401 FERNHOFF RD
OAKLAND CA
94619-3111
US

V. Phone/Fax

Practice location:
  • Phone: 510-928-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number8720
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: