Individual provider Active NPI

Lucy Song, M.D.

  • Hematology & Oncology Physician
  • Santa Clara, CA
National Provider Identifier
1699771030
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
G83036 Issued in CA
Practice address
710 Lawrence Expy
Oncology Dept #440
Santa Clara, CA 95051-5173
Phone
(408) 851-4323
Fax
(408) 851-4319
NPI assigned
Jun 21, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X G83036 CA Primary

Addresses

Primary practice location

710 Lawrence Expy
Oncology Dept #440
Santa Clara, CA 95051-5173

Mailing address

710 Lawrence Expy
Oncology Dept #440
Santa Clara, CA 95051-5173
Phone (408) 851-4323

Other identifiers 1

IdentifierTypeStateIssuer
64038599MedicaidKY

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
I20070524000753 CA Practitioner - Medical OncologyPractitioner - Hematology 4688771694 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G83036CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group Inc CurrentSince Oct 20, 2010 Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 20, 2010 Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

710 Lawrence Expy
#440
Santa Clara, CA 95051
Phone (408) 851-4316

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699771030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 LAWRENCE EXPY",
            "address_2": "ONCOLOGY DEPT #440",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515173",
            "telephone_number": "408-851-4323",
            "fax_number": "408-851-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LAWRENCE EXPY",
            "address_2": "ONCOLOGY DEPT #440",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515173",
            "telephone_number": "408-851-4323",
            "fax_number": "408-851-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "LUCY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G83036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64038599",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.