Healthcare Provider Details

I. General information

NPI: 1104812585
Provider Name (Legal Business Name): HIROFUMI HASHIMOTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WOODLAND RD
SAINT HELENA CA
94574-9554
US

IV. Provider business mailing address

10 WOODLAND RD
SAINT HELENA CA
94574-9554
US

V. Phone/Fax

Practice location:
  • Phone: 707-963-6399
  • Fax:
Mailing address:
  • Phone: 707-963-6399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG83463
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: