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General NPI Number Information
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NPI Number | 1326493990
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Entity Type | Individual
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Provider Name | JOSEPH SONG MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | FIRST AVENUE AT 16TH STREET BAIRD HALL, SUITE 16BH20
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City | NEW YORK
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State | NY
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Zip | 10003-3851
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Country | US
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Telephone | 212-420-4340
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 IOWA AVE STE 280
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City | RIVERSIDE
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State | CA
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Zip | 92507-7401
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Country | US
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Telephone | 951-786-0801
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C1-0027403
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A198988
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | V5608
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 306197
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License Number State | NY
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