Byron T Song, M.D. Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A21194 Issued in CA

Legal business name

BYRON T SONG, M.D. INC

Practice address

415 W Carroll Ave
Suite 202
Glendora, CA 91741-4208

Phone

(626) 963-1627

Fax

(626) 963-0467

NPI assigned

Jun 14, 2011

Last updated

Jun 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donna Lee Song, RN

Title

Corp. Secretary

Phone

(626) 963-1627

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308009600000",
    "number": "1629363908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W CARROLL AVE",
            "address_2": "SUITE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414208",
            "telephone_number": "626-963-1627",
            "fax_number": "626-963-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W CARROLL AVE",
            "address_2": "SUITE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414208",
            "telephone_number": "626-963-1627",
            "fax_number": "626-963-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYRON T SONG, M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CORP. SECRETARY",
        "authorized_official_telephone_number": "626-963-1627",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A21194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Glendora, CA
• Providers in Glendora, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.