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Individual

CHAEWON SONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12665 GARDEN GROVE BLVD, SUITE 503, GARDEN GROVE, CA 92843-1901
(714) 530-3740
(714) 530-0582
Mailing address
12665 GARDEN GROVE BLVD, SUITE 503, GARDEN GROVE, CA 92843-1901
(714) 530-3740
(714) 530-0582

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
C52295
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001397430
CT
Enumeration date
12/15/2005
Last updated
11/07/2013
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