Provider Demographics
NPI:1053423079
Name:HOFFMAN, SIM C (MD)
Entity type:Individual
Prefix:DR
First Name:SIM
Middle Name:C
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6800 LINCOLN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-4163
Mailing Address - Country:US
Mailing Address - Phone:714-995-5400
Mailing Address - Fax:714-995-5254
Practice Address - Street 1:6800 LINCOLN AVE STE 100
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4163
Practice Address - Country:US
Practice Address - Phone:714-995-5400
Practice Address - Fax:714-995-5254
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG436362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G436360Medicaid
CAWG43636GMedicare ID - Type UnspecifiedMEDICARE PPIN
CAA49414Medicare UPIN