=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598859654
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES STANLEY HOFF M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 05/20/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 999 S FAIRMONT AVE SUITE 135
-----------------------------------------------------
City | LODI
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95240-5100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-366-2060
-----------------------------------------------------
Fax | 209-366-2032
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 999 S FAIRMONT AVE SUITE 135
-----------------------------------------------------
City | LODI
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95240-5100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-642-4482
-----------------------------------------------------
Fax | 209-369-4880
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | G50029
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------