MEDICARE: DR EDWARD HOFFMAN PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	OS229	NV

General Provider Information

NPI Number	:	1013241033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR EDWARD HOFFMAN PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	8350 W SAHARA AVE
Second Line	:	270
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8939
Country	:	US
Telephone Number	:	702-243-8100
Fax Number	:	702-360-9416

Provider Business Practice Location Address
First Line	:	8350 W SAHARA AVE
Second Line	:	270
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8939
Country	:	US
Telephone Number	:	702-243-8100
Fax Number	:	702-360-9416

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDWARD HOFFMAN
Credential	:	DO
Telephone Number	:	702-243-8100

Provider Enumeration Date	:	09/23/2009
Last Update Date	:	03/07/2012

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