Healthcare Provider Details

I. General information

NPI: 1609715978
Provider Name (Legal Business Name): SHING HEI WONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4372 LADNER ST
FREMONT CA
94538-2838
US

IV. Provider business mailing address

4372 LADNER ST
FREMONT CA
94538-2838
US

V. Phone/Fax

Practice location:
  • Phone: 626-679-1712
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number66120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: