Active NPI
Grace Y Song, O.D.
- Optometrist
- Valencia, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12945T
- Practice address
- 24201 Valencia Blvd
Valencia Town Center
Valencia, CA 91355-1861 - Phone
- (661) 287-9893
- Fax
- (661) 287-3831
- NPI assigned
- Jan 15, 2007
- Last updated
- Mar 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12945T | CA | Primary |
Addresses
Primary practice location
24201 Valencia Blvd
Valencia Town Center
Valencia, CA 91355-1861
Mailing address
5413 Pine Glen Rd
La Crescenta, CA 91214-1423
Phone (917) 742-1684
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12945T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alan M Berg MD Inc and Robert E Feinfield MD Inc | Optometrist | Current | Accepting new patients |
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Healthcare Partners Affiliates Medical Group | Current | Accepting new patients | |
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
Locations
2625 W Alameda Ave
Ste 208
Burbank, CA 91505
Phone (818) 845-3557
824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706
13320 Riverside Dr
Ste 114
Sherman Oaks, CA 91423
Phone (818) 501-3937
Organizations & group practices 5
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.
-
- Ophthalmology Physician
- Burbank, CA
- NPI 1164567004
Optometrist
-
dba Optum
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1659312593
-
dba Optum
- Durable Medical Equipment & Medical Supplies
- Murrieta, CA
- NPI 1760057269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269302400000",
"number": "1821149063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5413 PINE GLEN RD",
"city": "LA CRESCENTA",
"state": "CA",
"postal_code": "912141423",
"telephone_number": "917-742-1684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24201 VALENCIA BLVD",
"address_2": "VALENCIA TOWN CENTER",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913551861",
"telephone_number": "661-287-9893",
"fax_number": "661-287-3831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "GRACE",
"middle_name": "Y",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2010-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12945T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.