Healthcare Provider Details

I. General information

NPI: 1699683615
Provider Name (Legal Business Name): YIN PUN WONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6865 W TROPICANA AVE
LAS VEGAS NV
89103-4383
US

IV. Provider business mailing address

230 E FLAMINGO RD UNIT 128
LAS VEGAS NV
89169-0311
US

V. Phone/Fax

Practice location:
  • Phone: 702-871-1623
  • Fax: 702-871-3314
Mailing address:
  • Phone: 808-597-7535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14291
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: