Individual
YONGHYEOK SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1161 E SHEPHERD AVE APT 104, FRESNO, CA 93720-1913
(917) 583-4662
Mailing address
5212 SHADOW STONE ST, BAKERSFIELD, CA 93313-4357
(917) 583-4662
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95357559
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
302859
AZ
367500000X
Certified Registered Nurse Anesthetist
95002837
CA
Other
Enumeration date
01/10/2024
Last updated
03/24/2026
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