Individual
KEVIN SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-5478
Mailing address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-5478
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
167965
CA
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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