Provider Demographics
NPI:1740455302
Name:HOFF, LARRY WAYNE (PA)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:WAYNE
Last Name:HOFF
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Gender:M
Credentials:PA
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Mailing Address - Street 1:DAVID GRANT USAF MEDICAL CENTER'S MCCLELLAN OUTPATIENT
Mailing Address - Street 2:5342 DUDLEY BLVD
Mailing Address - City:MCCLELLAN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95652
Mailing Address - Country:US
Mailing Address - Phone:916-561-7560
Mailing Address - Fax:916-561-7566
Practice Address - Street 1:DAVID GRANT USAF MEDICAL CENTER'S MCCLELLAN OUTPATIENT
Practice Address - Street 2:5342 DUDLEY BLVD
Practice Address - City:MCCLELLAN PARK
Practice Address - State:CA
Practice Address - Zip Code:95652
Practice Address - Country:US
Practice Address - Phone:916-561-7560
Practice Address - Fax:916-561-7566
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2023-07-18
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Provider Licenses
StateLicense IDTaxonomies
TNPA0000001218363A00000X
NDPAC0824363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant