Healthcare Provider Details

I. General information

NPI: 1881605848
Provider Name (Legal Business Name): ALLEN L HOFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 01/15/2010
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

4922 ANDASOL AVE
ENCINO CA
91316-3803
US

V. Phone/Fax

Practice location:
  • Phone: 818-345-9600
  • Fax: 818-345-9604
Mailing address:
  • Phone:
  • 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 StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: