Healthcare Provider Details

I. General information

NPI: 1669673109
Provider Name (Legal Business Name): DAVID R HOFSTETTER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 CROW CANYON RD #101
SAN RAMON CA
94583
US

IV. Provider business mailing address

2819 CROW CANYON RD #101
SAN RAMON CA
94583
US

V. Phone/Fax

Practice location:
  • Phone: 925-820-9355
  • Fax: 925-820-6335
Mailing address:
  • Phone: 925-820-9355
  • Fax: 925-820-6335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number21000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: