Provider Demographics
NPI:1114117660
Name:JAMES S. HOFF, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JAMES S. HOFF, M.D., A MEDICAL CORPORATION
Other - Org Name:JAMES S. HOFF, M.D., A PROFESSIONAL CORP.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-224-5719
Mailing Address - Street 1:999 S FAIRMONT AVE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-5100
Mailing Address - Country:US
Mailing Address - Phone:209-366-2031
Mailing Address - Fax:209-366-2032
Practice Address - Street 1:999 S FAIRMONT AVE
Practice Address - Street 2:SUITE 135
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-5100
Practice Address - Country:US
Practice Address - Phone:209-224-5719
Practice Address - Fax:209-691-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02108ZMedicare PIN