Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JONATHAN K SONG, D.O.
ActivePain Medicine (PM&R) · PEORIA, AZ
Registration Details
- NPI Number
- 1902260227
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 12, 2016 (10.024350980275 yrs)
- Last Updated
- Mar 21, 2025
- Licenses
-
009208 (AZ)009208 (AZ)
Practice Information
- Address
-
13943 N 91ST AVE BLDG EPEORIA, AZ, 853813629Browse AZ providers · Browse ZIP 85381
- Phone
- 6022628917
- Fax
- 6022628890
- Primary Specialty
-
Pain Medicine (PM&R)
2081P2900X
- Additional Specialty
- Physical Medicine & Rehabilitation
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.