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Individual

DR. JAEHA SONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2075 S COTTONWOOD DR, TEMPE, AZ 85282-3040
(480) 718-0568
Mailing address
2075 S COTTONWOOD DR, TEMPE, AZ 85282-3040
(480) 718-0568

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD-000896
AZ
213E00000X
Podiatrist
SC006500
PA
282N00000X
General Acute Care Hospital
65P97423
NY

Other

Enumeration date
07/09/2014
Last updated
04/30/2020
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