Basic Information
| Provider Information | |||||||||
| NPI: | 1679928774 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOFFNER | ||||||||
| FirstName: | LIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | MSC10 6000 | ||||||||
| Address2: | 1 UNIVERSITY OF NEW MEXICO | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | MSC10 6000 | ||||||||
| Address2: | 1 UNIVERSITY OF NEW MEXICO | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052722610 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2016 | ||||||||
| LastUpdateDate: | 09/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0000X | MD2021-0572 | NM | N | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 390200000X | NM | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | MD2021-0572 | NM | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.