Active NPI
Jianbo James Song, PHD
- Clinical Cytogenetics Physician
- San Jose, CA
National Provider Identifier
1043655640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cytogenetics Physician
- License
- MTO666
- Practice address
- 5755 Cottle Rd
Building 2 Genetics
San Jose, CA 95123-3640 - Phone
- (408) 972-3330
- NPI assigned
- May 8, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cytogenetics Physician | 207SC0300X | MTO666 | CA | Primary |
| Clinical Molecular Genetics Physician | 207SG0203X | MTP288 | CA |
Addresses
Primary practice location
5755 Cottle Rd
Building 2 Genetics
San Jose, CA 95123-3640
Mailing address
3145 Purdue Ave
Los Angeles, CA 90066-1405
Phone (310) 869-5572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MTO666 | CA | MD | Clinical Cytogenetics Physician |
| MTP288 | CA | MD | Clinical Molecular Genetics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367971200000",
"number": "1043655640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3145 PURDUE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661405",
"telephone_number": "310-869-5572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5755 COTTLE RD",
"address_2": "BUILDING 2 GENETICS",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951233640",
"telephone_number": "408-972-3330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "JIANBO",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-08",
"last_updated": "2013-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207SC0300X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Cytogenetics",
"state": "CA",
"license": "MTO666",
"primary": true
},
{
"code": "207SG0203X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Molecular Genetics",
"state": "CA",
"license": "MTP288",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.