Healthcare Provider Details

I. General information

NPI: 1861735318
Provider Name (Legal Business Name): SYLVIA VICKIE WONG PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 MANGROVE AVE
CHICO CA
95926-3947
US

IV. Provider business mailing address

7735 S OAK WAY
SACRAMENTO CA
95831-4451
US

V. Phone/Fax

Practice location:
  • Phone: 530-891-6722
  • Fax:
Mailing address:
  • Phone: 916-718-8048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number68249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: