Individual
DEBORAH SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
Mailing address
15811 ROSALITA DR, LA MIRADA, CA 90638-4133
(626) 758-2920
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95003112
CA
Other
Enumeration date
10/20/2015
Last updated
03/13/2017
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