Active NPI
Mihyang Song, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Roseville, CA
National Provider Identifier
1235601733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 79625
- Practice address
- 4001 Impala Cir
Roseville, CA 95678-6744 - Phone
- (212) 470-9926
- NPI assigned
- Dec 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 79625 | CA | Primary |
Addresses
Primary practice location
4001 Impala Cir
Roseville, CA 95678-6744
Mailing address
4001 Impala Cir
Roseville, CA 95678-6744
Phone (212) 470-9926
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79625 | Other | CA | CALIFORNIA BOARD OF PHARMACY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 79625 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1235601733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 IMPALA CIR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956786744",
"telephone_number": "212-470-9926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 IMPALA CIR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956786744",
"telephone_number": "212-470-9926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "MIHYANG",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-20",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "79625",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF PHARMACY",
"identifier": "79625",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.