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NPI Code Detail

MEDICARE: SOPHIA SONG

MEDICARE: SOPHIA 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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1962359158
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA SONG
Provider Business Mailing Address
First Line : 4245 S GRAND CANYON DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-7161
Country : US
Telephone Number : 702-825-8106
Fax Number :
Provider Business Practice Location Address
First Line : 4245 S GRAND CANYON DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-7161
Country : US
Telephone Number : 702-825-8106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ SOPHIA SONG ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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