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Individual

SUNAH SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
26001 REDLANDS BLVD # 117, REDLANDS, CA 92373
(909) 894-7677
Mailing address
26001 REDLANDS BLVD # 117, REDLANDS, CA 92373-7762
(909) 894-7677

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NP 20746
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NP 20746
CALIFORNIA BOARD OF NURSING
CA
01
RN 635805
CALIFORNIA BOARD OF NURSING
CA
Enumeration date
11/04/2008
Last updated
05/23/2018
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