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1538342043
JACK JAEYOUNG SONG
MARTINEZ, CA
NPI
1538342043
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA A85362)
Enumeration Date
2007-12-07
Last Update Date
2022-02-11
Business Address
JACK JAEYOUNG SONG
2500 ALHAMBRA AVE
MARTINEZ, CA 94553-3156
Phone number: 925-370-5110
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Mailing Address
JACK JAEYOUNG SONG
1515 NEWELL AVE
WALNUT CREEK, CA 94596-5120
Phone number: 925-295-4000
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