Provider Demographics
NPI:1417007782
Name:HOFFMAN, JOAN FAITH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:FAITH
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2240 GLADSTONE DR. #4
Mailing Address - Street 2:LA CLINICA - PITTSBURG
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5126
Mailing Address - Country:US
Mailing Address - Phone:925-431-1230
Mailing Address - Fax:707-442-6602
Practice Address - Street 1:2240 GLADSTONE DR. #4
Practice Address - Street 2:LA CLINICA - PITTSBURG
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5126
Practice Address - Country:US
Practice Address - Phone:925-431-1230
Practice Address - Fax:707-442-6602
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG77232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF68192Medicare UPIN
CA00G77232Medicare ID - Type Unspecified