Active NPI
Joyce Song, DO
- Pediatrics Physician
- Escondido, CA
National Provider Identifier
1417510694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A20032
- Practice address
- 625 Citracado Pkwy Ste 200
Escondido, CA 92025-6428 - Phone
- (760) 746-2641
- NPI assigned
- Apr 15, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 10828 | GA | |
| Pediatrics Physician | 208000000X | 20A20032 | CA | Primary |
Addresses
Primary practice location
625 Citracado Pkwy Ste 200
Escondido, CA 92025-6428
Mailing address
625 Citracado Pkwy Ste 200
Escondido, CA 92025-6428
Phone (760) 746-2641
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A20032 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662076800000",
"number": "1417510694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 CITRACADO PKWY STE 200",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920256428",
"telephone_number": "760-746-2641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 CITRACADO PKWY STE 200",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920256428",
"telephone_number": "760-746-2641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "JOYCE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-15",
"last_updated": "2022-09-02",
"certification_date": "2022-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "10828",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A20032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.