Healthcare Provider Details

I. General information

NPI: 1255318440
Provider Name (Legal Business Name): BERNARD HERBERT HOFMANN D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 CRAVEN ST BLDG 3230
SAN DIEGO CA
92136-5596
US

IV. Provider business mailing address

3000 UPAS ST APT 214
SAN DIEGO CA
92104-4285
US

V. Phone/Fax

Practice location:
  • Phone: 619-556-8253
  • Fax:
Mailing address:
  • Phone: 619-556-8253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN14312
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: