MEDICARE: DR. SEUNG-YIL SONG M.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	207RX0202X	Medical Oncology Physician	A25278	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	953302834	OTHER	CA	TAX ID

General Provider Information

NPI Number	:	1578677860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEUNG-YIL SONG M.D.

Provider Business Mailing Address
First Line	:	7930 FROST ST STE 405
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2759
Country	:	US
Telephone Number	:	858-571-2811
Fax Number	:	858-571-2814

Provider Business Practice Location Address
First Line	:	7930 FROST ST STE 405
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2759
Country	:	US
Telephone Number	:	858-571-2811
Fax Number	:	858-571-2814

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	08/05/2025

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