Healthcare Provider Details

I. General information

NPI: 1689660433
Provider Name (Legal Business Name): ANTHONY R. HOFFMAN, DPM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 W EATON AVE
TRACY CA
95376-3420
US

IV. Provider business mailing address

461 W EATON AVE
TRACY CA
95376-3420
US

V. Phone/Fax

Practice location:
  • Phone: 209-830-6738
  • Fax: 209-830-1959
Mailing address:
  • Phone: 209-830-6738
  • Fax: 209-830-1959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4106
License Number StateCA

VIII. Authorized Official

Name: DR. ANTHONY R. HOFFMAN
Title or Position: OWNER
Credential: D.P.M.
Phone: 510-830-6738