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Organization
MENLO DERMATOLOGY MEDICAL GROUP AND LASER CENTER INC
Active
Organization
MENLO DERMATOLOGY MEDICAL GROUP AND LASER CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS EDWARD HOFFMAN M.D. (PRESIDENT)
(650) 325-1511
Entity
Organization
Contact information
Practice address
888 OAK GROVE AVE, SUITE 8, MENLO PARK, CA 94025-4432
(650) 325-1511
(650) 325-6174
Mailing address
888 OAK GROVE AVE, SUITE 8, MENLO PARK, CA 94025-4432
(650) 325-1511
(650) 325-6174
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
26176
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ15375Z
MEDICARE PTAN
CA
Enumeration date
02/27/2006
Last updated
08/25/2015
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