Young Eun Song

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95010329 Issued in CA

Practice address

1120 W la Veta Ave Ste 300
Orange, CA 92868-4246

Phone

(714) 598-1745

Fax

(714) 941-9539

NPI assigned

Dec 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• J Young Medical Clinic Inc

  • Pain Management Registered Nurse
  • Buena Park, CA
  • NPI 1790656734
  Medicare reassignment NPD Authorized official
• Spine and Sports Specialities Medical Group

  • Orthopaedic Surgery Physician
  • Orange, CA
  • NPI 1013306174
  Medicare reassignment NPD

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

{
    "created_epoch": "1545609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1700358116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CRESCENT OAK",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W LA VETA AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684246",
            "telephone_number": "714-598-1745",
            "fax_number": "714-941-9539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 Warner Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927806444",
            "country_code": "US",
            "telephone_number": "714-258-7116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "YOUNG EUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-24",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95010329",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP95010329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jong Tae Song, DDS
• Lina Qi Song
• Sarah E Song
• Seon Song
• Sikai Song, MD
• Amit Soni, M.D
• Niki Prakash Soni
• Michele Sonnier, RN
• Sonoran Medical Services PC
• Sonus-USA, Inc.

• Adult Health Nurse Practitioner in Orange, CA
• Providers in Orange, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.