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

Jack Jaeyoung Song

Individual provider Family Medicine Physician · NPI 1538342043

Jack Jaeyoung Song is a Family Practice in Martinez, California. Graduated from Illinois Medical College in 2001, 25 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
25
Trained at
Illinois Medical College
Licensed in
CA
In the registry since
2007
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2500 Alhambra Ave
Martinez, CA 94553-3156
Phone: (925) 370-5110
Fax: (925) 370-5142
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A85362 (CA)

Record details

NPI number1538342043
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 7, 2007
Last updated in NPPESFebruary 11, 2022

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolILLINOIS MEDICAL COLLEGE
Graduated 2001 (25 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Martinez