Healthcare Provider Details

I. General information

NPI: 1740731066
Provider Name (Legal Business Name): ALEXANDER E HOFFMAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MERCED ST
SAN LEANDRO CA
94577-4201
US

IV. Provider business mailing address

2133 SANTA CLARA AVE APT 207
ALAMEDA CA
94501-2870
US

V. Phone/Fax

Practice location:
  • Phone: 510-454-7285
  • Fax:
Mailing address:
  • Phone: 510-846-2117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number53901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: