Provider Demographics
NPI:1437133394
Name:HOFFMAN, DANIEL ADAM SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ADAM SCOTT
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N ROBERTSON BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2121
Mailing Address - Country:US
Mailing Address - Phone:310-657-9200
Mailing Address - Fax:310-657-9210
Practice Address - Street 1:150 N ROBERTSON BLVD STE 115
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2121
Practice Address - Country:US
Practice Address - Phone:310-657-9200
Practice Address - Fax:310-657-9210
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013352207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI137993OtherCARE-PREFERRED CHOICES
MI137993OtherCARE-PREFERRED CHOICES
MI0M92440018Medicare PIN
MI1437133394Medicaid
MI0M92440018Medicare PIN
MI121783OtherGREAT LAKES HEALTH PLAN
MI700H217350OtherBLUE SHIELD
MI137993OtherCARE-PREFERRED CHOICES