| Doctor Name: | ANNIE SONG |
| NPI Number: | 1871965749 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 049012 |
| Business Practice Address: | 21263 Erwin St Woodland Hills, CA - 913673715 |
| Business Phone Number: | 8185923028 |
| Business Fax Number: | |
| Mailing Address: | 21263 Erwin St, WOODLAND HILLS |
| State: | CA |
| Postal Code: | 913673715 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/30/2015 |
| NPI Last Update Date: | 10/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 049012 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |