Provider Demographics
NPI:1407298623
Name:HOFFMAN, MITCHELL (RN)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2549 EASTBLUFF DR STE B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3599
Mailing Address - Country:US
Mailing Address - Phone:949-436-4210
Mailing Address - Fax:
Practice Address - Street 1:2549 EASTBLUFF DR STE B
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3599
Practice Address - Country:US
Practice Address - Phone:949-436-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275803163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency