Active NPI
Lian Soung, M.D.
- Nephrology Physician
- Stockton, CA
National Provider Identifier
1174510747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- A33597
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A335970 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090316000179 | CA | Practitioner - Internal Medicine | 4587682976 | Practice locations: Stockton, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- 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
- Good Samaritan Rehab and Care Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A33597 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daisy Li, DO, Inc. | Past | Accepting new patients | |
| George R Herron Jr MD Inc | Internal Medicine | Past | 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.
-
- Family Medicine Physician
- Stockton, CA
- NPI 1558933374
-
- Preferred Provider Organization
- San Ramon, CA
- NPI 1679011035
-
- Nephrology Physician
- Stockton, CA
- NPI 1790110880
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Stockton, CA
- NPI 1528190931
-
- Skilled Nursing Facility
- Stockton, CA
- NPI 1548283542
Nursing home
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.