NA Young Song, D.O., a Professional Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NA YOUNG SONG, D.O., A PROFESSIONAL CORPORATION

Practice address

2001 S Barrington Ave Ste 111
Los Angeles, CA 90025-5337

Phone

(424) 625-8897

NPI assigned

Dec 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. NA Young Song, DONPI 1871723122

Title

Ceo, Cfo, Secretary

Phone

(424) 625-8897

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• NA Young Song, DO

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1871723122
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1104634963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE STE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255337",
            "telephone_number": "424-625-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE STE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255337",
            "telephone_number": "424-625-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NA YOUNG SONG, D.O., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "NA YOUNG",
        "authorized_official_title_or_position": "CEO, CFO, SECRETARY",
        "authorized_official_telephone_number": "424-625-8897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.