Individual
CHARLES LUCKY SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2390 PACIFIC AVE, LONG BEACH, CA 90806-3051
(562) 988-1863
Mailing address
2390 PACIFIC AVE, LONG BEACH, CA 90806-3051
(562) 988-1863
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
11/20/2020
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