Song of Phoenix

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

197607370 Issued in CA

Legal business name

SONG OF PHOENIX

Practice address

22302 Halldale Ave
Torrance, CA 90501-4232

Phone

(310) 320-5350

Fax

(310) 320-5350

NPI assigned

May 14, 2015

Organization subpart

No

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

Authorized official

Name

Roger Brito

Title

Administrator

Phone

(424) 376-8931

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1740668490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22302 HALLDALE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905014232",
            "telephone_number": "310-320-5350",
            "fax_number": "310-320-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22302 HALLDALE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905014232",
            "telephone_number": "310-320-5350",
            "fax_number": "310-320-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONG OF PHOENIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "BRITO",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "424-376-8931"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "197607370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RCFE LICENSE",
            "identifier": "1976077370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mansoureh Soltani, DDS
• Seun Akinvowale Somadhi
• Jina J Son, O.D.
• John S Son, O.D.
• Sung Jun Son, MD
• Lawrence Curtis Song, D.D.S.
• Mina Song, BI
• Phornnatcha Songkaew
• Sonia Rebeles, MD Inc
• Sonny Rubin, M.D., Inc

• Assisted Living Facility in Torrance, CA
• Providers in Torrance, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.