Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ilseong Song, PT, DPT

Individual provider Physical Therapist · NPI 1871050245

Ilseong Song, PT, DPT is a Physical Therapist in Private Practice in San Diego, California. Qualified in 2018, 8 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2019
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

7340 Miramar Rd Ste 210
San Diego, CA 92126-4224
Phone: (858) 284-1133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3145 Rosecrans St Ste F, San Diego, CA 92110-4831 — (619) 223-7175
  • 3959 Ruffin Rd Ste J, San Diego, CA 92123-1830 — (858) 279-5570

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 295985 (CA)

Record details

NPI number1871050245
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorYes
NPI enumeratedFebruary 21, 2019
Last updated in NPPESSeptember 26, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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