Provider Demographics
NPI:1588863096
Name:HOFFMAN, TONYA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:MARIE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TONYA
Other - Middle Name:MARIE
Other - Last Name:SOUTHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1815 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-3202
Mailing Address - Country:US
Mailing Address - Phone:707-542-9644
Mailing Address - Fax:405-347-7291
Practice Address - Street 1:1815 4TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-3202
Practice Address - Country:US
Practice Address - Phone:707-542-9644
Practice Address - Fax:405-347-7291
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102147207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine