Healthcare Provider Details

I. General information

NPI: 1902306400
Provider Name (Legal Business Name): KAORU HASHIMOTO SONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2018
Last Update Date: 06/16/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL (BDAACH) UNIT #15245; BLDG 3031
APO CA
96271
US

IV. Provider business mailing address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL (BDAACH) UNIT #15245; BLDG 3031
APO CA
96271
US

V. Phone/Fax

Practice location:
  • Phone: 315-737-3554
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number32109
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: