Provider Demographics
NPI:1174571731
Name:HOFFMAN, ROBERT A (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2390 E BIDWELL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3872
Mailing Address - Country:US
Mailing Address - Phone:916-983-6211
Mailing Address - Fax:916-983-6608
Practice Address - Street 1:2390 E BIDWELL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3872
Practice Address - Country:US
Practice Address - Phone:916-983-6211
Practice Address - Fax:916-983-6608
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9263T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0092630Medicaid
CASD0092630Medicaid
CAT88800Medicare UPIN