Song, Chaewon
Song, Chaewon is an sole proprietor health care provider with primary practice located at 12665 Garden Grove Blvd Suite 503, Garden Grove CA 92843-1901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Song, Chaewon can be contacted via phone (714) 530-3740.Contact Information
Primary practice address
12665 Garden Grove Blvd Suite 503
Garden Grove CA 92843-1901
Phone: (714) 530-3740
Fax: (714) 530-0582
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | C52295 | California |
Profile Details
| NPI number | 1972589687 |
|---|---|
| LBN Legal business name | Song, Chaewon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 15th, 2005 |
| Last updated | Nov 7th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972589687 | NPPES |
| Connecticut | MEDICAID | 001397430 |
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