Provider Demographics
NPI:1437190501
Name:HOFFMAN, DARYL KRISTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:KRISTIN
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 EL CAMINO REAL
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2315
Mailing Address - Country:US
Mailing Address - Phone:650-325-1118
Mailing Address - Fax:650-321-8943
Practice Address - Street 1:805 EL CAMINO REAL
Practice Address - Street 2:SUITE A
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2315
Practice Address - Country:US
Practice Address - Phone:650-325-1118
Practice Address - Fax:650-321-8943
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG059181174400000X, 208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No174400000XOther Service ProvidersSpecialist
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG059181OtherLICENSE
CA27-1713045OtherGROUP TAX ID
CAE27409Medicare UPIN