Healthcare Provider Details

I. General information

NPI: 1487206108
Provider Name (Legal Business Name): YUE SONG MD, MPH, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVENUE WARD 6D23
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

1001 POTRERO AVENUE WARD 6D23
SAN FRANCISCO CA
94110
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-3060
  • Fax:
Mailing address:
  • Phone: 628-206-3060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA190701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: