MR. GARETH HUANG SONG (NPI# 1356805717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356805717 |
| Entity Type | Individual |
| Full Name | MR. GARETH HUANG SONG |
| Practice Address |
986 Sweetbriar Ln Unit A Azusa CA 91702-1569 |
| Practice Telephone | 9093195838 |
| Mailing Telephone | 9093195838 |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
9510957 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
9510957 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BOARD OF REGISTERED NURSING- NURSE PRACTITIONER | 95010957 | 01 |
| Street Address |
986 SWEETBRIAR LN UNIT A |
| City | AZUSA |
| State | CA |
| Zip Code | 91702-1569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407345341 | Rosaura Contreras | Nutritionist | 109 West 6th Street, Azusa, CA 91702 | 2018-05-07 |
| 1093224396 | Beatriz Leyva Torres | Nurse Practitioner | 237 S. Vernon Ave, Azusa, CA 91702 | 2017-09-29 |
| 1871949370 | Angela Marie Mckindley | Case Manager/Care Coordinator | 23701 East Fork Rd., Azusa, CA 91702 | 2016-05-13 |
| 1023489846 | Crystal Horton | Case Manager/Care Coordinator | 23701 E Fork Road, Azusa, CA 91702 | 2015-10-20 |
| 1528438272 | Seann Mckay | Case Manager/Care Coordinator | 23701 E Folk Rd, Azusa, CA 91702 | 2015-10-06 |
| 1437528833 | William Clabaugh | Case Manager/Care Coordinator | 830 S. Azusa Ave., 45, Azusa, CA 91702 | 2015-09-16 |
| 1467850693 | Juana Gaeta | Speech-Language Pathologist | 1016 E Ghent St, Azusa, CA 91702 | 2014-12-22 |
| 1649674508 | Colleen Anne Montz | Nurse Practitioner | 901 E. Alosta Ave., Student Health Center, Azusa, CA 91702 | 2014-10-21 |
| 1285061390 | Patrick Ryan Bergeron | Physical Therapist | 900 W Sierra Madre Avenue, #33, Azusa, CA 91702 | 2013-10-03 |
| 1760768972 | Ashley L Wickliffe | Student in an Organized Health Care Education/Training Program | 901 East Alosta Avenue, Azusa, CA 91702 | 2011-11-01 |
| Find all providers in zip 91702 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
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| 1174139109 | Lena Kazanchyan | Nurse Practitioner | 11834 Archwood St, North Hollywood, CA 91606-1603 | 2020-09-16 |
| 1740898386 | Victor De Guzman | Nurse Practitioner | 24808 Sand Wedge Ln, Valencia, CA 91355-2315 | 2020-07-20 |
| 1114535937 | Ashley Elizabeth Rosso | Nurse Practitioner | 3111 Camino Del Rio N Ste 625, San Diego, CA 92108-5718 | 2020-07-17 |
| 1518586452 | Zaruhi Harutyunyan | Nurse Practitioner | 7901 Santa Monica Blvd Ste 206, West Hollywood, CA 90046-5180 | 2020-04-10 |
| 1457986168 | Maritza J Lira | Nurse Practitioner | 23141 Verdugo Dr Ste 201, Laguna Hills, CA 92653-1341 | 2020-03-03 |
| 1225677198 | Shannon Ha Duyen Sicat | Nurse Practitioner | 2617 E Chapman Ave Ste 109, Orange, CA 92869-3245 | 2019-12-24 |
| 1528605961 | Elsa L Pineda-flores | Nurse Practitioner | 1513 S Grand Ave Ste 306, Los Angeles, CA 90015-3075 | 2019-12-04 |
| 1447895073 | Kemi Osilesi | Nurse Practitioner | 1943 Seasons St, Simi Valley, CA 93065-0580 | 2019-11-07 |
| 1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
| 1255993531 | May Therese Ronci | Nurse Practitioner | 38504 Cougar Pass, Palmdale, CA 93551-5019 | 2019-07-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.