Healthcare Provider Details

I. General information

NPI: 1285706796
Provider Name (Legal Business Name): IRWIN HOFFMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 WESTLAKE BLVD SUITE 211
WESTLAKE VILLAGE CA
91361
US

IV. Provider business mailing address

1240 WESTLAKE BLVD SUITE 211
WESTLAKE VILLAGE CA
91361
US

V. Phone/Fax

Practice location:
  • Phone: 805-494-4957
  • Fax: 805-494-0157
Mailing address:
  • Phone: 805-494-4957
  • Fax: 805-494-0157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY4424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: