Provider Demographics
NPI:1275752560
Name:HOFFMAN, MARGARET ALICE (PAC)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ALICE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 OAKDALE LN
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-3447
Mailing Address - Country:US
Mailing Address - Phone:559-925-8630
Mailing Address - Fax:
Practice Address - Street 1:609 W ACEQUIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6129
Practice Address - Country:US
Practice Address - Phone:559-625-9902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 16000363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP51844Medicare UPIN