Healthcare Provider Details

I. General information

NPI: 1114177110
Provider Name (Legal Business Name): PATSY KONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DIVISADERO ST # H5309 BOX 1712, MZ INFUSION CENTER
SAN FRANCISCO CA
94115-3010
US

IV. Provider business mailing address

1600 DIVISADERO ST # H5309 BOX 1712, MZ INFUSION CENTER
SAN FRANCISCO CA
94115-3010
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7053
  • Fax: 415-353-7089
Mailing address:
  • Phone: 415-353-7053
  • Fax: 415-353-7089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRPH56457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: