Individual
LINDA HYUNAE SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2646
CO
152W00000X
Optometrist
OPT11216TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2646
STATE LICENSE
CO
01
—
OPT11216TPA
STATE LICENSE NUMBER
CA
Enumeration date
08/20/2006
Last updated
04/07/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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