| Ellen Song Md Inc. | |
|
62 Corporate Park Suite 235 Irvine CA 92606-3122 | |
| (949) 748-8866 | |
| (949) 748-8868 |
| Full Name | Ellen Song Md Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 62 Corporate Park, Irvine, California |
| Authorized Official Name and Position | Ellen Teresa Song (OWNER) |
| Authorized Official Contact | 9497488866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Song Md Inc. 62 Corporate Park Suite 235 Irvine CA 92606-3122 Ph: (949) 748-8866 | Ellen Song Md Inc. 62 Corporate Park Suite 235 Irvine CA 92606-3122 Ph: (949) 748-8866 |
| NPI Number | 1437340692 |
|---|---|
| Provider Enumeration Date | 08/05/2007 |
| Last Update Date | 08/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437340692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A86825 (California) | Primary |
| 208000000X | Pediatrics | A86825 (California) | Secondary |
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