Provider Demographics
NPI:1134157910
Name:HOFFMANN, KLAUS DIETRICH (MD)
Entity type:Individual
Prefix:
First Name:KLAUS
Middle Name:DIETRICH
Last Name:HOFFMANN
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 1:6323 N FRESNO ST
Mailing Address - Street 2:#105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-431-0995
Mailing Address - Fax:559-431-0998
Practice Address - Street 1:6323 N FRESNO ST
Practice Address - Street 2:#105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-431-0995
Practice Address - Fax:559-431-0998
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31069207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0018510Medicaid
CA0044113OtherPIN NUMBER
CA00A310690Medicare ID - Type Unspecified
CA0044113OtherPIN NUMBER