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

Justin Seungbae Song

Individual provider Physician Assistant · NPI 1346717675

Justin Seungbae Song is a Physician Assistant in Compton, California. Qualified in 2018, 8 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2018

Practice location Address checks out

2499 S Wilmington Ave
Compton, CA 90220-5434
Phone: (310) 638-1113
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 56155 (CA)

Record details

NPI number1346717675
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 24, 2018
Last updated in NPPESOctober 27, 2023
Mailing address6717 Kings Harbor Dr, Rancho Palos Verdes, CA 90275-4619

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
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
Practice locations4 on file with Medicare

Other providers in Compton