Provider Demographics
NPI:1770453409
Name:HOFFMAN, JASON R (LAC)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:R
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 NORTH LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ALDADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001
Mailing Address - Country:US
Mailing Address - Phone:626-258-7793
Mailing Address - Fax:626-398-8776
Practice Address - Street 1:1927 NORTH LAKE AVE
Practice Address - Street 2:
Practice Address - City:ALDADENA
Practice Address - State:CA
Practice Address - Zip Code:91001
Practice Address - Country:US
Practice Address - Phone:626-258-7793
Practice Address - Fax:626-398-8776
Is Sole Proprietor?:No
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10758171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist