Basic Information
| Provider Information | |||||||||
| NPI: | 1396958161 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARK G HOFFMAN, M.D., INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3782 | ||||||||
| Address2: | |||||||||
| City: | PINEDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936503782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594360871 | ||||||||
| FaxNumber: | 5594365221 | ||||||||
| Practice Location | |||||||||
| Address1: | 6145 N THESTA ST | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937105266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594360871 | ||||||||
| FaxNumber: | 5594365221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HOFFMAN | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5594360871 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | G69733 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.