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Mr. Gareth Huang Song
Gerontology Nurse Practitioner in Azusa, California
NPI 1356805717

Gareth Huang Song is a Gerontology Nurse Practitioner based in Azusa, CA and is specialized in Gerontology. Gareth Huang Song practices in Azusa, CA. The NPI Number for Gareth Huang Song is 1356805717 and holds a License No. 9510957 (California).

The current practice location address for Gareth Huang Song is 986 Sweetbriar Ln Unit A, Azusa, CA and can be reached out via phone at 909-319-5838.

Location: 986 Sweetbriar Ln Unit A, Azusa, CA, 91702-1569
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356805717
Provider Name
Gareth Huang Song
Credential
Provider Entity Type
Individual
Gender
Male
Address
986 Sweetbriar Ln Unit A, Azusa, CA, 91702-1569
Phone Number
909-319-5838
Fax Number
Provider Enumeration Date
01/29/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
95010957 01 CA BOARD OF REGISTERED NURSING- NURSE PRACTITIONER
institution
Provider Business Practice Location Address Details
Address
986 Sweetbriar Ln Unit A
City
Azusa
State
California
Zip
91702-1569
Phone Number
909-319-5838
Fax Number
person
Provider Business Mailing Address Details
Address
986 Sweetbriar Ln Unit A
City
Azusa
State
California
Zip
91702-1569
Phone Number
909-319-5838
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
9510957 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
363LP2300X
License No.
9510957 (California)
Definition
Definition to come...
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