Provider Demographics
NPI:1598859654
Name:HOFF, JAMES STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STANLEY
Last Name:HOFF
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 1:999 S FAIRMONT AVE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-5100
Mailing Address - Country:US
Mailing Address - Phone:209-642-4482
Mailing Address - Fax:209-369-4880
Practice Address - Street 1:999 S FAIRMONT AVE
Practice Address - Street 2:SUITE 135
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-5100
Practice Address - Country:US
Practice Address - Phone:209-366-2060
Practice Address - Fax:209-366-2032
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50029207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G500290Medicaid
CA00G500291Medicare PIN
CAA51542Medicare UPIN
CA00G500290Medicaid