Provider Demographics
NPI:1437145380
Name:HOFFMAN, ROBERT BAKER (DC, RN, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BAKER
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DC, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14683 DEON DR
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-9662
Mailing Address - Country:US
Mailing Address - Phone:512-799-1609
Mailing Address - Fax:
Practice Address - Street 1:18880 CHERRY VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:TUOLUMNE
Practice Address - State:CA
Practice Address - Zip Code:95379
Practice Address - Country:US
Practice Address - Phone:209-928-5400
Practice Address - Fax:209-928-5412
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX778738363LF0000X
TX8101111N00000X
TXAP121902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX002065301Medicaid
TX002065301Medicaid
TXU72988Medicare UPIN