Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC28175 | CA |
NPI | 1629189857 |
---|---|
Provider Name | Dr. Danny Song |
First Address | San Diego, CA 92121-1733 |
Second Address | San Diego, CA 92121-1733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 14/05/2014 |