Dr. Charles H Song, M.D.
Pediatrics, Pediatric Allergy/Immunology in Los Angeles, CA. Individual provider (NPI-1).
NPI number1790792869
StatusActive
Last updated in NPPESJul 5, 2018
Details
- NPI
- 1790792869
- Entity type
- Individual (NPI-1)
- Name
- Dr. Charles H Song
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 2, 2006
- Last updated
- Jul 5, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0201X | Pediatrics, Pediatric Allergy/Immunology | G23461 | CA | Yes |
| 174400000X | Specialist | G23461 | CA |
Practice location
200 Medical Plaza Suite 265Los Angeles, CA 90095-6814
Phone 310-825-0867
Mailing address
5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631
Other practice locations
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