Healthcare Provider Details

I. General information

NPI: 1346327343
Provider Name (Legal Business Name): ALLEN L. HOFFMAN, MD FACS, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18411 CLARK ST SUITE 305
TARZANA CA
91356-3506
US

IV. Provider business mailing address

18411 CLARK ST SUITE 305
TARZANA CA
91356-3506
US

V. Phone/Fax

Practice location:
  • Phone: 818-345-9600
  • Fax:
Mailing address:
  • Phone: 818-345-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG72104
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberG72104
License Number StateCA

VIII. Authorized Official

Name: DR. ALLEN L HOFFMAN
Title or Position: CEO
Credential: M.D.
Phone: 818-345-9600