Provider Demographics
NPI:1629332614
Name:DON SON, MD, INC.
Entity Type:Organization
Organization Name:DON SON, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:DONGSOO
Authorized Official - Last Name:SON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-527-2240
Mailing Address - Street 1:408 S BEACH BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-1878
Mailing Address - Country:US
Mailing Address - Phone:714-527-2240
Mailing Address - Fax:714-527-2328
Practice Address - Street 1:408 S BEACH BLVD STE 206
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-1853
Practice Address - Country:US
Practice Address - Phone:714-527-2240
Practice Address - Fax:714-527-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA121306261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6977240Medicaid