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General NPI Number Information
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NPI Number | 1649241050
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Entity Type | Organization
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Legal Business Name | HARVEY HASHIMOTO MD INC
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 801 S HAM LN #5
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City | LODI
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State | CA
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Zip | 95242
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Country | US
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Telephone | 209-333-8066
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Fax | 209-333-1029
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Provider Business Mailing Address
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Address Line | PO BOX 986
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City | WOODBRIDGE
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State | CA
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Zip | 95258-0986
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Country | US
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Telephone | 209-333-8066
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Fax | 209-333-1029
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Authorized Official
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Title or Position | CEO
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Name | MR. HARVEY HASHIMOTO
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Credential | MD
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Telephone | 209-333-8066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G55355
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License Number State | MD
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