Provider Demographics
NPI:1720173347
Name:HOFFMANN, TAMAR (MD)
Entity Type:Individual
Prefix:
First Name:TAMAR
Middle Name:
Last Name:HOFFMANN
Suffix:
Gender:F
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:PO BOX 592
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-0592
Mailing Address - Country:US
Mailing Address - Phone:808-597-8808
Mailing Address - Fax:808-597-1201
Practice Address - Street 1:1150 S KING ST
Practice Address - Street 2:#908
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1922
Practice Address - Country:US
Practice Address - Phone:808-597-8808
Practice Address - Fax:808-597-1201
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 6321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI055604Medicaid
HI64006OtherHMSA (BC/BS)
HIMD6321-02OtherMDX HAWAII
HI00E0064005OtherHMSA
HIMD6321-02OtherMDX HAWAII
HI000BDQGBMedicare ID - Type Unspecified
HIE15081Medicare UPIN