Individual
JOO LEE SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4650 W SUNSET BLVD, MS 68, LOS ANGELES, CA 90027-6062
(323) 361-2113
Mailing address
4650 W SUNSET BLVD, MS 68, LOS ANGELES, CA 90027-6062
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A129660
CA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
A129660
CA
Other
Enumeration date
01/05/2015
Last updated
04/13/2023
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