Healthcare Provider Details

I. General information

NPI: 1659555241
Provider Name (Legal Business Name): HING KA WONG PEARSON PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HING KA WONG PHARM.D

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 NORTH AVE
GRAND JUNCTION CO
81501-6428
US

IV. Provider business mailing address

2121 NORTH AVE
GRAND JUNCTION CO
81501-6428
US

V. Phone/Fax

Practice location:
  • Phone: 970-263-2800
  • Fax:
Mailing address:
  • Phone: 970-263-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17906
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3177
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: