Healthcare Provider Details

I. General information

NPI: 1497051189
Provider Name (Legal Business Name): BRIAN HOFER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 W CAMERON AVE
VISALIA CA
93277-9527
US

IV. Provider business mailing address

1405 W CAMERON AVE
VISALIA CA
93277-9527
US

V. Phone/Fax

Practice location:
  • Phone: 559-636-9783
  • Fax: 559-636-0314
Mailing address:
  • Phone: 559-636-9783
  • Fax: 559-636-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: