1720173347 NPI number — TAMAR HOFFMANN MD

Table of content: TAMAR HOFFMANN MD (NPI 1720173347)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720173347 NPI number — TAMAR HOFFMANN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFFMANN
Provider First Name:
TAMAR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720173347
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 592
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANEOHE
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96744-0592
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-597-8808
Provider Business Mailing Address Fax Number:
808-597-1201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1150 S KING ST
Provider Second Line Business Practice Location Address:
#908
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-1922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-597-8808
Provider Business Practice Location Address Fax Number:
808-597-1201
Provider Enumeration Date:
10/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD 6321 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 055604 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64006 . This is a "HMSA (BC/BS)" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: MD6321-02 . This is a "MDX HAWAII" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00E0064005 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".