Individual
GRACE Y SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
24201 VALENCIA BLVD, VALENCIA TOWN CENTER, VALENCIA, CA 91355-1861
(661) 287-9893
(661) 287-3831
Mailing address
5413 PINE GLEN RD, LA CRESCENTA, CA 91214-1423
(917) 742-1684
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12945T
CA
Other
Enumeration date
01/15/2007
Last updated
03/23/2010
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