Provider Demographics
NPI:1023011459
Name:HOFFMAN, ANTHONY R (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:R
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20130 LAKE CHABOT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5340
Mailing Address - Country:US
Mailing Address - Phone:510-278-9350
Mailing Address - Fax:510-481-7490
Practice Address - Street 1:15035 E 14TH ST STE A
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1901
Practice Address - Country:US
Practice Address - Phone:510-278-9350
Practice Address - Fax:510-481-7490
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4106213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E41060Medicaid
CAE4106OtherSTATE OF CA LICENSE
CA000E41061Medicaid
CA000E41060Medicaid
CA000E41061Medicare PIN