NPIMap

Individual provider Active NPI

James I Song, PHARM. D.

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1104095884
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
42830 Issued in CA
Practice address
4220 W 3Rd St
Suite 100
Los Angeles, CA 90020-3450
Phone
(213) 384-3405
Fax
(213) 384-3406
NPI assigned
Feb 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42830 CA Primary

Addresses

Primary practice location

4220 W 3Rd St
Suite 100
Los Angeles, CA 90020-3450

Mailing address

4220 W 3Rd St
Suite 100
Los Angeles, CA 90020-3450
Phone (213) 384-3405

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
42830CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
James Song Pharm.D. Pharmacy Inc. Current Accepting new patients

Locations

4220 W 3rd St
Ste 100
Los Angeles, CA 90020
Phone (213) 384-3405

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1104095884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 W 3RD ST",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203450",
            "telephone_number": "213-384-3405",
            "fax_number": "213-384-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W 3RD ST",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203450",
            "telephone_number": "213-384-3405",
            "fax_number": "213-384-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JAMES",
        "middle_name": "I",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-26",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "42830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; 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.