Blake Song
Blake Song is a Student in an Organized Health Care Education/Training Program in Costa Mesa, California. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
940 S Coast Dr Ste 225Costa Mesa, CA 92626-7757
Phone: (949) 743-1457
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1114660891 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 19, 2022 |
| Last updated in NPPES | April 19, 2022 |
| Certification date | April 19, 2022 |
| Mailing address | 4711 W 166th St, Lawndale, CA 90260-2828 |
Other providers in Costa Mesa
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Alyssa M Serpa, MA
940 S Coast Dr Ste 225, Costa Mesa, CA 92626-7757 · (949) 743-1457
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James Kent Severance
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Andrew Pierre Shahid
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Kai Filip Smith
940 S Coast Dr, Costa Mesa, CA 92626-7735 · (949) 743-1457
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Lauren Thaxter, MA
940 S Coast Dr Ste 225, Costa Mesa, CA 92626-7757 · (949) 743-1457
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Grace Thompson, MA
940 S Coast Dr Ste 225, Costa Mesa, CA 92626-7757 · (949) 743-1457
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Aly Tierney, MA
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Dr. Lana Tran, DDS
3133 Boston Way, Costa Mesa, CA 92626-2705 · (714) 675-8547