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General NPI Number Information
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NPI Number | 1700358116
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Entity Type | Individual
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Provider Name | YOUNG EUN SONG
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Gender | Female
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Dates
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Enumeration Date | 12/24/2018
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 1120 W LA VETA AVE STE 300
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City | ORANGE
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State | CA
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Zip | 92868-4246
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Country | US
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Telephone | 714-598-1745
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Fax | 714-941-9539
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Provider Business Mailing Address
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Address Line | 2101 CRESCENT OAK
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City | IRVINE
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State | CA
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Zip | 92618-4019
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95010329
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | NP95010329
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License Number State | CA
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