Provider Demographics
NPI:1184806689
Name:KLAUS D. HOFFMANN, M.D., INC.
Entity type:Organization
Organization Name:KLAUS D. HOFFMANN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:DR
Authorized Official - First Name:KLAUS
Authorized Official - Middle Name:DIETRICH
Authorized Official - Last Name:HOFFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-431-0995
Mailing Address - Street 1:6323 N FRESNO ST
Mailing Address - Street 2:ST#105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5282
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:ST#105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5282
Practice Address - Country:US
Practice Address - Phone:559-431-0995
Practice Address - Fax:559-431-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31069207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0018510Medicaid
CA00A310690OtherMEDICARE #
CAA26336Medicare UPIN