Provider Demographics
NPI:1801857875
Name:HOFFER, TERRENCE LEE (MD)
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:LEE
Last Name:HOFFER
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 1:441 COLUSA AVE
Mailing Address - Street 2:STE C
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991
Mailing Address - Country:US
Mailing Address - Phone:530-671-4930
Mailing Address - Fax:530-671-0219
Practice Address - Street 1:441 COLUSA AVE
Practice Address - Street 2:STE C
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991
Practice Address - Country:US
Practice Address - Phone:530-671-4930
Practice Address - Fax:530-671-0219
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37707207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C377070Medicaid
A36734Medicare UPIN
CA00C377070Medicaid