Provider Demographics
NPI:1366761413
Name:HOFFMAN, JUSTIN N (NMD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:N
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 PROFESSIONAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3028
Mailing Address - Country:US
Mailing Address - Phone:707-292-8882
Mailing Address - Fax:888-445-4625
Practice Address - Street 1:2230 PROFESSIONAL DR STE C
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3028
Practice Address - Country:US
Practice Address - Phone:707-292-8882
Practice Address - Fax:888-445-4625
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1695175F00000X
CA441175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath