Chaewon Song, MD, Inc

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

C52295 Issued in CA

Legal business name

CHAEWON SONG, MD, INC

Practice address

12665 Garden Grove Blvd
Suite 503
Garden Grove, CA 92843-1901

Phone

(714) 534-6516

Fax

(714) 530-0582

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Chaewon SongNPI 1972589687

Title

M.D.

Phone

(714) 534-6516

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Chaewon Song, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Garden Grove, CA
  • NPI 1972589687
  Medicare reassignment NPD Authorized official
• Shieun Hong

  • Adult Health Nurse Practitioner
  • Garden Grove, CA
  • NPI 1922467299
  Medicare reassignment NPD
• Hong Sik Kim, M.D.

  • Nephrology Physician
  • Garden Grove, CA
  • NPI 1396727764
  Medicare reassignment NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1265502017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 503",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-534-6516",
            "fax_number": "714-530-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 503",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-534-6516",
            "fax_number": "714-530-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAEWON SONG, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "CHAEWON",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "714-534-6516"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "C52295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Cesena
• Erica Chacon Cabadas
• Armando Chacon
• Ryan O Chadderton, PSYD.
• In Hwa Chae, MS, OTR/L
• Heba Chakoukani Jubran, PHARMD
• Stacey Chambers, MSW, MPH, ASW
• Chan Woo Lee Medical Inc.
• Chan Woo Lee Medical, Inc.
• Alex Chan

• Geriatric Medicine (Internal Medicine) Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Geriatric Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.