Healthcare Provider Details

I. General information

NPI: 1023592342
Provider Name (Legal Business Name): ROBERT DAVID HOFFMAN L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 7TH ST STE 301
SANTA MONICA CA
90401-2632
US

IV. Provider business mailing address

10461 WYSTONE AVE
NORTHRIDGE CA
91326-3059
US

V. Phone/Fax

Practice location:
  • Phone: 213-792-2825
  • Fax:
Mailing address:
  • Phone: 310-806-1097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC16879
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: