Healthcare Provider Details

I. General information

NPI: 1336393974
Provider Name (Legal Business Name): CHUNG-WEN WANG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WHEELING ST
AURORA CO
80045-7211
US

IV. Provider business mailing address

1700 WHEELING ST
AURORA CO
80045-7211
US

V. Phone/Fax

Practice location:
  • Phone: 720-723-7140
  • Fax:
Mailing address:
  • Phone: 720-723-7140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 60355
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number60355
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: