Active NPI
Angela Song Landfair, M.D.
- Plastic Surgery Physician
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- MT186868
- Practice address
- 1425 S Main St FL 3
Walnut Creek, CA 94596-5318 - Phone
- (925) 295-5885
- NPI assigned
- Aug 17, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | MT186868 | PA | Primary |
Addresses
Primary practice location
1425 S Main St FL 3
Walnut Creek, CA 94596-5318
Mailing address
1 Westwood CT
Orinda, CA 94563-3112
Phone (412) 401-5102
Other names 1
- Dr. Angela Yunyoung Song
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT186868 | PA | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group, Inc | Current | Accepting new patients | |
| University of Utah Plastic Surgery Associates | Plastic Surgery | Past | Accepting new patients |
Locations
1800 Harrison St
Fl 7
Oakland, CA 94612
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
1425 S Main St
Walnut Creek, CA 94596
Phone (925) 295-4130
1425 S Main St
Fl 3
Walnut Creek, CA 94596
Phone (925) 295-4655
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
-
- Internal Medicine Physician
- Vallejo, CA
- NPI 1336222397
-
- Clinical Medical Laboratory
- San Jose, CA
- NPI 1497971584
-
- Plastic Surgery Physician
- Salt Lake City, UT
- NPI 1326057258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1043466410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WESTWOOD CT",
"city": "ORINDA",
"state": "CA",
"postal_code": "945633112",
"telephone_number": "412-401-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 S MAIN ST FL 3",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945965318",
"telephone_number": "925-295-5885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDFAIR",
"first_name": "ANGELA",
"middle_name": "SONG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-17",
"last_updated": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "PA",
"license": "MT186868",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1425 S Main St",
"city": "Walnut Creek",
"state": "CA",
"country_code": "US",
"postal_code": "945965318",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "SONG",
"middle_name": "YUNYOUNG",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.