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

Tae Kyung Song, MD

Individual provider Vascular Surgery Physician · NPI 1043407430

Tae Kyung Song, MD is a Vascular Surgery in Stanford, California. Graduated from University of Vermont College of Medicine in 2001, 25 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
25
Trained at
University of Vermont College of Medicine
Licensed in
CA
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

300 Pasteur Dr Rm H3600
Stanford, CA 94305-2200
Phone: (650) 723-3639
Show map & directions

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

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence A81297 (CA)

Record details

NPI number1043407430
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 28, 2007
Last updated in NPPESNovember 30, 2021

Medicare enrollment

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

Medicare specialtyVASCULAR SURGERY
Medical schoolUNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Graduated 2001 (25 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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