Individual
BRIAN KOFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1514 VALLEY VISTA DR, DIAMOND BAR, CA 91765-3929
(909) 860-1144
(909) 860-8307
Mailing address
1514 VALLEY VISTA DR, DIAMOND BAR, CA 91765-3929
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G36410
CA
Other
Enumeration date
08/02/2005
Last updated
09/19/2018
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