Healthcare Provider Details

I. General information

NPI: 1477802429
Provider Name (Legal Business Name): MAY WONG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST PHARMACY SERVICE 119
SAN FRANCISCO CA
94121
US

IV. Provider business mailing address

4150 CLEMENT ST PHARMACY SERVICE 119
SAN FRANCISCO CA
94121
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: