NPIMap

Individual provider Active NPI

James H Song, M.D.

  • Specialist
  • City of Industry, CA
National Provider Identifier
1679662217
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G75661 Issued in CA
Practice address
1661 Hanover Rd
103A
City of Industry, CA 91748-1796
Phone
(626) 581-8330
Fax
(626) 581-8411
NPI assigned
Oct 12, 2006
Last updated
Nov 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G75661 CA Primary

Addresses

Primary practice location

1661 Hanover Rd
103A
City of Industry, CA 91748-1796

Mailing address

16404 Colima Rd FL 1
Hacienda Heights, CA 91745-5502
Phone (626) 581-8330

Other identifiers 1

IdentifierTypeStateIssuer
00G756610MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041104000748 CA Practitioner - Internal MedicinePractitioner - General Practice 0749243418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Tufts University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16404 Colima Rd
Hacienda Heights, CA 91745-5502
Phone (626) 581-8330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G75661CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
St Jude Hospital Inc Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Excel Multi-Specialty Medical Group Specialist Past Accepting new patients
James Song MD, a Professional Corporation Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Casey Fu Single Specialty Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Park Regency Care CenterLa Habra, CA, CCN 555536 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2022
Aug 1, 2022
Cedar Pine Post AcutePasadena, CA, CCN 555213 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2023
Dec 1, 2023
Better Health Home CareWest Covina, CA, CCN 057753 Home health agency Corporate Director Mar 1, 2006

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1679662217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16404 COLIMA RD FL 1",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917455502",
            "telephone_number": "626-581-8330",
            "fax_number": "626-581-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 HANOVER RD",
            "address_2": "103A",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481796",
            "telephone_number": "626-581-8330",
            "fax_number": "626-581-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JAMES",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G75661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G756610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in City of Industry, CA

Sources for this page

Verify at the official NPI Registry.