Healthcare Provider Details

I. General information

NPI: 1275176182
Provider Name (Legal Business Name): STEVEN WANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 CASTRO ST
SAN FRANCISCO CA
94114-2019
US

IV. Provider business mailing address

445 CASTRO ST
SAN FRANCISCO CA
94114-2019
US

V. Phone/Fax

Practice location:
  • Phone: 800-436-7119
  • Fax: 800-821-2529
Mailing address:
  • Phone: 800-436-7119
  • Fax: 800-821-2529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: