MEDICARE: DR. ESTHER INHAE SONG PHARM. D

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
1	1835P1200X	Pharmacotherapy Pharmacist	45482	CA

General Provider Information

NPI Number	:	1467544395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ESTHER INHAE SONG PHARM. D

Provider Business Mailing Address
First Line	:	1851 PALM AVE
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94061
Country	:	US
Telephone Number	:	650-849-0566
Fax Number	:

Provider Business Practice Location Address
First Line	:	1851 PALM AVE
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94061-2612
Country	:	US
Telephone Number	:	650-849-0566
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

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