Healthcare Provider Details

I. General information

NPI: 1497439632
Provider Name (Legal Business Name): CHRISTOPHER JIN-LIAN WANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 HOWE ST
OAKLAND CA
94611-5312
US

IV. Provider business mailing address

5947 HIGHWOOD RD
CASTRO VALLEY CA
94552-1823
US

V. Phone/Fax

Practice location:
  • Phone: 410-908-3268
  • Fax:
Mailing address:
  • Phone: 410-908-3268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number54402
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: