Ellen Song MD Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A86825 Issued in CA

Legal business name

ELLEN SONG MD INC.

Practice address

62 Corporate Park
Suite 235
Irvine, CA 92606-3122

Phone

(949) 748-8866

Fax

(949) 748-8868

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ellen Teresa Song, M.D.

Title

Owner

Phone

(949) 748-8866

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1437340692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CORPORATE PARK",
            "address_2": "SUITE 235",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926063122",
            "telephone_number": "949-748-8866",
            "fax_number": "949-748-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CORPORATE PARK",
            "address_2": "SUITE 235",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926063122",
            "telephone_number": "949-748-8866",
            "fax_number": "949-748-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEN SONG MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-748-8866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A86825",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A86825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Elizabeth, CMT
• Patricia Elizarraras
• Alyssa Briann Elizondo
• Ella Davies Individual & Family Therapy, Inc
• Ellen Kotkin Licensed Clinical Social Worker Professional Corp
• Laura Ellenwood, LMFT
• Kim Ellingson, D.C.
• Krista Elliott
• Breana Ellis
• Ryan Scott Ellis

• Internal Medicine Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.