Provider Demographics
NPI:1003827718
Name:HOFSTADTER, ANN L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:L
Last Name:HOFSTADTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 N ROXBURY DR
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5027
Mailing Address - Country:US
Mailing Address - Phone:310-273-3230
Mailing Address - Fax:
Practice Address - Street 1:435 N ROXBURY DR
Practice Address - Street 2:SUITE 404
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5027
Practice Address - Country:US
Practice Address - Phone:310-273-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA052890174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG32893Medicare UPIN
CAWA52890AMedicare PIN