Healthcare Provider Details

I. General information

NPI: 1154527109
Provider Name (Legal Business Name): AIMEE A HOFFMAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 BISHOP ST STE 430
SAN LUIS OBISPO CA
93401-4663
US

IV. Provider business mailing address

1551 BISHOP ST STE 430
SAN LUIS OBISPO CA
93401-4663
US

V. Phone/Fax

Practice location:
  • Phone: 805-261-1044
  • Fax: 805-364-3290
Mailing address:
  • Phone: 805-261-1044
  • Fax: 805-364-3290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA19113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: