Healthcare Provider Details

I. General information

NPI: 1528184785
Provider Name (Legal Business Name): EDWARD HOFFMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 W SAHARA AVE 270
LAS VEGAS NV
89117-8939
US

IV. Provider business mailing address

8350 W SAHARA AVE 270
LAS VEGAS NV
89117-8939
US

V. Phone/Fax

Practice location:
  • Phone: 702-243-8100
  • Fax: 702-360-9416
Mailing address:
  • Phone: 702-243-8100
  • Fax: 702-360-9416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS229
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: