Individual
DIANE JUNGYUN SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
26926 THE OLD RD, VALENCIA, CA 91381-0662
(661) 310-3445
(661) 310-1999
Mailing address
26926 THE OLD RD, VALENCIA, CA 91381-0662
(661) 310-3445
(661) 310-1999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT11750T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0117500
—
CA
Enumeration date
08/25/2005
Last updated
08/06/2007
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