Provider Demographics
NPI:1780841536
Name:HOFFMAN, ROBERT S
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23123 VENTURA BLVD
Mailing Address - Street 2:100
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1104
Mailing Address - Country:US
Mailing Address - Phone:818-222-3823
Mailing Address - Fax:818-222-3827
Practice Address - Street 1:23123 VENTURA BLVD
Practice Address - Street 2:100
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1104
Practice Address - Country:US
Practice Address - Phone:818-222-3823
Practice Address - Fax:818-222-3827
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0218772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB50990Medicare UPIN