Yong Jae Song MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

YONG JAE SONG MD INC

Practice address

6731 Ridge Rd
Suite 302
Parma, OH 44129-5708

Phone

(440) 843-7772

Fax

(440) 845-0430

NPI assigned

Jan 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yong J. Song, M.D.

Title

Owner

Phone

(440) 843-7772

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273708800000",
    "number": "1053478297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6731 RIDGE RD",
            "address_2": "SUITE 302",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295708",
            "telephone_number": "440-843-7772",
            "fax_number": "440-845-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6731 RIDGE RD",
            "address_2": "SUITE 302",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295708",
            "telephone_number": "440-843-7772",
            "fax_number": "440-845-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YONG JAE SONG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-05-13",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "YONG",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-843-7772",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0897589",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley M Yassall, CDCA
• Shirley Ching Yee, PA-C
• Sherry Yelland, PSYCHOLOGIST
• Sergey Yevtukh
• Shawniece Yoder
• Mary Yutzy
• Lori Zabak, LPN
• Mallory Zabor, PMHNP-BC
• Zaccardelli and Ritz
• William Zaccardelli

• Internal Medicine Physician in Parma, OH
• Providers in Parma, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.