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Individual

KIT M SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3160 GENEVA STREET, SHRINERS HOSPITALS FOR CHILDREN LOS ANGELES, LOS ANGELES, CA 90020
(213) 368-3338
(213) 368-3314
Mailing address
PO BOX 8500, LOCKBOX 7642, SHRINERS HOSPITALS FOR CHILDREN, PHILADELPHIA, PA 19178-7642
(813) 281-8478
(813) 281-8113

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD00024272
WA
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
MD00024272
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7115
INTERNAL ID-MOTOR VEHICLE ID
05
8186215
WA
Enumeration date
10/17/2006
Last updated
02/06/2013
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