Individual
CHANEL SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5154 W SUNSET BLVD, LOS ANGELES, CA 90027-5708
(213) 718-1535
Mailing address
5154 W SUNSET BLVD, LOS ANGELES, CA 90027-5708
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5749
CA
Other
Enumeration date
11/26/2021
Last updated
11/26/2021
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