Individual provider Active NPI

David D Song, M.D./PH.D

  • Neurology Physician
  • Riverside, CA
National Provider Identifier
1679599765
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A72825 Issued in CA
Practice address
4646 Brockton Ave Ste 302-2
Riverside, CA 92506-0174
Phone
(951) 742-5255
Fax
(951) 717-8609
NPI assigned
Jul 14, 2006
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A72825 CA Primary

Addresses

Primary practice location

4646 Brockton Ave Ste 302-2
Riverside, CA 92506-0174

Mailing address

1501 Violet St
Colton, CA 92324-1603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120113000263 CA Practitioner - Neurology 1052588126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Tulane University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
California University of Science and MedicineGroup PAC ID 4880949106, 8 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 966-4910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as group
Quality
82.43
Promoting interoperability
100
Improvement activities
40
Cost
65.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
72825CAMDPharmacist
A72825CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California University of Science and Medicine Neurology CurrentSince Jan 1, 2025 Accepting new patients
Cusm Health Neurology CurrentSince Mar 24, 2025 Accepting new patients
University Surgeons of Orange a Medical Group Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

1501 Violet St
Colton, CA 92324
Phone (909) 580-9661

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

4646 Brockton Ave
Ste 302-2
Riverside, CA 92506
Phone (951) 742-5255

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1679599765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 VIOLET ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE STE 302-2",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060174",
            "telephone_number": "951-742-5255",
            "fax_number": "951-717-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "DAVID",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D./PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A72825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.