Healthcare Provider Details

I. General information

NPI: 1093889685
Provider Name (Legal Business Name): ZHENKAI SONG M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 W BEVERLY BLVD
MONTEBELLO CA
90640-4308
US

IV. Provider business mailing address

PO BOX 148
CLAREMONT CA
91711-0148
US

V. Phone/Fax

Practice location:
  • Phone: 323-725-4256
  • Fax:
Mailing address:
  • Phone: 909-985-2112
  • Fax: 909-985-3411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ZHENKAI SONG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 909-985-2112