Active NPI
Tara Elena Song, MD
- Otolaryngology Physician
- Panorama City, CA
National Provider Identifier
1457640914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- A125132
- Practice address
- 8110 Woodman Ave
Dept of Head and Neck Surgery
Panorama City, CA 91402 - Phone
- (818) 375-2732
- NPI assigned
- Apr 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | A125132 | CA | Primary |
Addresses
Primary practice location
8110 Woodman Ave
Dept of Head and Neck Surgery
Panorama City, CA 91402
Mailing address
8110 Woodman Ave
Dept of Head and Neck Surgery
Panorama City, CA 91402
Phone (303) 324-4690
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A125132 | CA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473292800000",
"number": "1457640914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8110 WOODMAN AVE",
"address_2": "DEPT OF HEAD AND NECK SURGERY",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "91402",
"telephone_number": "303-324-4690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8110 WOODMAN AVE",
"address_2": "DEPT OF HEAD AND NECK SURGERY",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "91402",
"telephone_number": "818-375-2732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "TARA",
"middle_name": "ELENA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-05",
"last_updated": "2016-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "A125132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panorama City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.