Individual
DR. ANGIE U. SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1225 N H ST, LOMPOC, CA 93436-3301
(805) 737-8700
(805) 737-8649
Mailing address
3655 EVERGREEN PT RD, MEDINA, WA 98039
(425) 324-6144
(425) 455-0045
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
60136134
WA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
G84700
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174028401
—
TX
01
—
8S2230
BCBS
TX
Enumeration date
08/09/2005
Last updated
05/10/2019
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