Healthcare Provider Details

I. General information

NPI: 1871130146
Provider Name (Legal Business Name): WENDY NGA WING CHENG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 LAS GALLINAS AVE
SAN RAFAEL CA
94903
US

IV. Provider business mailing address

950 LAS GALLINAS AVE
SAN RAFAEL CA
94903
US

V. Phone/Fax

Practice location:
  • Phone: 415-472-8221
  • Fax:
Mailing address:
  • Phone: 415-472-8221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number80027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: