Provider Demographics
NPI:1831179712
Name:HASHIMOTO, KEN (MD)
Entity type:Individual
Prefix:DR
First Name:KEN
Middle Name:
Last Name:HASHIMOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 DAVID AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-5508
Mailing Address - Country:US
Mailing Address - Phone:831-641-7280
Mailing Address - Fax:831-641-7281
Practice Address - Street 1:80 GARDEN CT STE 101
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5367
Practice Address - Country:US
Practice Address - Phone:831-641-7280
Practice Address - Fax:831-641-7281
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I12525Medicare UPIN