Individual provider Active NPI

Joseph Sung Eun Song

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1518798354
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
920 Weyburn Place
Aloe, 404
Los Angeles, CA 90024
Phone
(847) 542-8232
NPI assigned
Aug 13, 2024
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

920 Weyburn Place
Aloe, 404
Los Angeles, CA 90024

Mailing address

920 Weyburn Place
Aloe, 404
Los Angeles, CA 90024
Phone (847) 542-8232

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1518798354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 WEYBURN PLACE",
            "address_2": "ALOE, 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90024",
            "telephone_number": "847-542-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WEYBURN PLACE",
            "address_2": "ALOE, 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90024",
            "telephone_number": "847-542-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JOSEPH",
        "middle_name": "SUNG EUN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.