Provider Demographics
NPI:1265964795
Name:SONG, ALEXANDER HANJOON (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:HANJOON
Last Name:SONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:541 W COLORADO ST STE 205
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-3640
Mailing Address - Country:US
Mailing Address - Phone:323-794-1403
Mailing Address - Fax:323-488-9782
Practice Address - Street 1:1245 WILSHIRE BLVD STE 303
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4803
Practice Address - Country:US
Practice Address - Phone:213-977-1214
Practice Address - Fax:213-482-8868
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA184827207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology