Provider Demographics
NPI:1285706796
Name:HOFFMAN, IRWIN (PHD)
Entity type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 WESTLAKE BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361
Mailing Address - Country:US
Mailing Address - Phone:805-494-4957
Mailing Address - Fax:805-494-0157
Practice Address - Street 1:1240 WESTLAKE BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:805-494-4957
Practice Address - Fax:805-494-0157
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4424103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP4424Medicare ID - Type Unspecified