Soomchungmdoncology-Hematologypc

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

A41090 Issued in CA

Legal business name

SOOMCHUNGMDONCOLOGY-HEMATOLOGYPC

Practice address

12555 Garden Grove Blvd Ste 309
Garden Grove, CA 92843-1903

Phone

(714) 539-6414

Fax

(714) 539-6933

NPI assigned

Feb 12, 2008

Organization subpart

No

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

Authorized official

Name

Soo Marn Chung, M.D.

Title

Ceo

Phone

(714) 539-6414

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1386812394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 GARDEN GROVE BLVD STE 309",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431903",
            "telephone_number": "714-539-6414",
            "fax_number": "714-539-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 GARDEN GROVE BLVD STE 309",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431903",
            "telephone_number": "714-539-6414",
            "fax_number": "714-539-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOOMCHUNGMDONCOLOGY-HEMATOLOGYPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "SOO",
        "authorized_official_middle_name": "MARN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-539-6414",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A41090",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A41090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A410900",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0675453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chaewon Song, MD
• Chanyang Song
• Inchul Song, AC
• Min Seon Song, LAC
• Jaskiran Kaur Soomal
• Sekboppa Sor, FNP-C
• Melody Soria
• Jasmine Soriano
• Vincent Jose Balenbin Soriano
• Sonia Sorto

• Hematology & Oncology Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.