MEDICARE: DR. LEON HOFFMAN O.D.

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	152W00000X	Optometrist	OP5875T	CA

General Provider Information

NPI Number	:	1861589608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEON HOFFMAN O.D.

Provider Business Mailing Address
First Line	:	113 E BROADWAY
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1006
Country	:	US
Telephone Number	:	818-241-7719
Fax Number	:	818-241-0507

Provider Business Practice Location Address
First Line	:	113 E BROADWAY
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1006
Country	:	US
Telephone Number	:	818-241-7719
Fax Number	:	818-241-0507

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	08/12/2011

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