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NPI Code Detail

MEDICARE: CHRISTINA SONG

MEDICARE: CHRISTINA SONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist55155CA

General Provider Information

NPI Number : 1265703888
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA SONG
Provider Business Mailing Address
First Line : 350 BRODERICK ST APT 310
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94117-2278
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1363 DIVISADERO ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-3912
Country : US
Telephone Number : 415-931-9974
Fax Number : 415-931-9825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2012
Last Update Date : 01/13/2012

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Directions to “ CHRISTINA SONG ” Practice Location

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