Healthcare Provider Details

I. General information

NPI: 1629391875
Provider Name (Legal Business Name): JAMES L. HOFF O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 ABBOT KINNEY BLVD.
VENICE CA
90291
US

IV. Provider business mailing address

1636 ABBOT KINNEY BLVD
VENICE CA
90291-3745
US

V. Phone/Fax

Practice location:
  • Phone: 310-452-4633
  • Fax: 310-452-0624
Mailing address:
  • Phone: 310-452-4633
  • Fax: 310-452-0624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number10034T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: