Search › California › 363LF0000X
Ji Yeong Gendron Song
NPI 1033788898 · on the registry since 2021 · sole proprietor
Practice
- Address
- 738 Bancroft Road
Walnut Creek, CA 94598 - Phone
- (925) 938-8525
- Organisation at this address
- Longs Drug Stores California Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 19
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Also registered as
- 363LF0000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-06-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California