Individual provider Active NPI

Lian Soung, M.D.

  • Nephrology Physician
  • Stockton, CA
National Provider Identifier
1174510747
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A33597 Issued in CA
Practice address
1610 N El Dorado St
Suite 17
Stockton, CA 95204-5930
Phone
(209) 465-5107
Fax
(209) 465-7653
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A33597 CA
Nephrology Physician 207RN0300X A33597 CA Primary

Addresses

Primary practice location

1610 N El Dorado St
Suite 17
Stockton, CA 95204-5930

Mailing address

1610 N El Dorado St
Suite 17
Stockton, CA 95204-5930
Phone (209) 465-5107

Other identifiers 1

IdentifierTypeStateIssuer
00A335970MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090316000179 CA Practitioner - Internal MedicinePractitioner - Nephrology 4587682976 Practice locations: Stockton, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1525 N Eldorado St
Suite 1
Stockton, CA 95204-5903
Phone (209) 465-5107

Hospital & facility affiliations

  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
  • Good Samaritan Rehab and Care Center Nursing home, Stockton, CA, CCN 055039

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A33597CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daisy Li, DO, Inc. Past Accepting new patients
George R Herron Jr MD Inc Internal Medicine PastSince Nov 4, 2008 Accepting new patients
Stockton Nephrology, Inc. Nephrology Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174510747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 N EL DORADO ST",
            "address_2": "SUITE 17",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045930",
            "telephone_number": "209-465-5107",
            "fax_number": "209-465-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 N EL DORADO ST",
            "address_2": "SUITE 17",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045930",
            "telephone_number": "209-465-5107",
            "fax_number": "209-465-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUNG",
        "first_name": "LIAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A33597",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A33597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A335970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.