Healthcare Provider Details

I. General information

NPI: 1023901428
Provider Name (Legal Business Name): BRYAN J HOFILENA RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 TELEGRAPH AVE STE 350
OAKLAND CA
94609-3239
US

IV. Provider business mailing address

3100 TELEGRAPH AVE STE 350
OAKLAND CA
94609-3239
US

V. Phone/Fax

Practice location:
  • Phone: 818-970-1450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95136806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: