Provider Demographics
NPI:1841486115
Name:HOFFMAN, GRACE IMPERIAL (OTRL)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:IMPERIAL
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19191 S VERMONT AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1018
Mailing Address - Country:US
Mailing Address - Phone:310-327-9101
Mailing Address - Fax:310-327-6611
Practice Address - Street 1:19191 S VERMONT AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1018
Practice Address - Country:US
Practice Address - Phone:310-327-9101
Practice Address - Fax:310-327-6611
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6118225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist