Mark M. Song, M.D., Inc.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A49785 Issued in CA

Legal business name

MARK M. SONG, M.D., INC.

Practice address

1401 S Brookhurst Rd Ste 115
Fullerton, CA 92833-4492

Phone

(714) 626-0700

Fax

(714) 626-0800

NPI assigned

Jul 1, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mark Myungjae Song, M.D.NPI 1326068560

Title

President

Phone

(714) 626-0700

Specialties & licenses 2

Addresses

Tax ID family

Mark M Song MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mark M. Song M.D., Inc.

  • Nephrology Physician
  • El Monte, CA
  • NPI 1972944684
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Myungjae Song, MD, PHD

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1326068560
  NPD (past) Authorized official

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1467892745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BROOKHURST RD STE 115",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334492",
            "telephone_number": "714-626-0700",
            "fax_number": "714-626-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BROOKHURST RD STE 115",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334492",
            "telephone_number": "714-626-0700",
            "fax_number": "714-626-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK M. SONG, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "MYUNGJAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-626-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A49785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marinelli & Feldman MDS
• Derrick V Marinelli, M.D.
• Donna Marino, DO
• Michael Marino, D.O.
• Marites Perez Lunastar, Dental Practice Inc (Lunastar Dental)
• Kasey Markell, MS, ATC
• Kelly Markham
• Lily Reve Markle
• Dominick Isaiah Marmolejo I
• Adriana Marquez-Gallegos

• Nephrology Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.