TAE KYUNG SONG M.D. NPI 1043407430

NPI Information

  • NPI: 1043407430
  • Provider Name: TAE KYUNG SONG, M.D.
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 300 PASTEUR DR
    ROOM H3600
    STANFORD, CA
    ZIP 94305
  • Phone: (650) 723-3639

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NPI Details

Tae Kyung Song, M.D. is a vascular surgery surgery in Stanford, CA with 24 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Tae Kyung Song, M.D. NPI is 1043407430. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Graduation Year:2001

The provider's business location address is:

300 PASTEUR DR
ROOM H3600
STANFORD, CA
ZIP 94305-200
Phone: (650) 723-3639

The NPI 1043407430 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Leg revascularization (restoring blood flow) (HCPCS:NAN01)

The enumeration date for this NPI number is 9/28/2007 and was last updated on 11/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular SurgeryA81297CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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