Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | A91732 | CA |
Y | 2080P0201X | Pediatric Allergist | A91732 | CA |
N | 2080P0216X | Pediatric Rheumatologist | A91732 | CA |
NPI | 1235251216 |
---|---|
Provider Name | Dr. Steven Jonghun Song |
First Address | Richmond, CA 94801-3143 |
Second Address | Richmond, CA 94801-3143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 15/12/2021 |