Provider Demographics
NPI:1619956695
Name:HOFFMAN, DAVID NOLAN (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NOLAN
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8165 E WARDLOW RD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3204
Mailing Address - Country:US
Mailing Address - Phone:562-598-7673
Mailing Address - Fax:
Practice Address - Street 1:8165 E WARDLOW RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-3204
Practice Address - Country:US
Practice Address - Phone:562-598-7673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12584T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0125840Medicaid
CASD0125840Medicaid
CA0798100001Medicare NSC
CAWOP12584AMedicare PIN