Provider Demographics
NPI:1578766937
Name:SONG, RUBENS J (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBENS
Middle Name:J
Last Name:SONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:110 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1708
Mailing Address - Country:US
Mailing Address - Phone:323-857-2724
Mailing Address - Fax:323-857-3894
Practice Address - Street 1:6041 CADILLAC AVE
Practice Address - Street 2:STE 249
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1702
Practice Address - Country:US
Practice Address - Phone:323-857-2724
Practice Address - Fax:323-857-3894
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2021-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA97410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine