Provider Demographics
NPI:1720217730
Name:HOEFER, ELIZABETH STARR (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:STARR
Last Name:HOEFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30372 ESPERANZA
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2180
Mailing Address - Country:US
Mailing Address - Phone:949-589-9962
Mailing Address - Fax:949-589-8462
Practice Address - Street 1:30372 ESPERANZA
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2180
Practice Address - Country:US
Practice Address - Phone:949-589-9962
Practice Address - Fax:949-589-8462
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA457AMedicare PIN