Individual
DR. ELLEN TERESA SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16300 SAND CANYON AVE STE 209, IRVINE, CA 92618-3712
(949) 216-6900
(949) 387-5130
Mailing address
16300 SAND CANYON AVE STE 209, IRVINE, CA 92618-3712
(949) 216-6900
(949) 387-5130
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A86825
CA
208000000X
Pediatrics Physician
Primary
A86825
CA
Other
Enumeration date
08/11/2006
Last updated
12/19/2013
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