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General NPI Number Information
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NPI Number | 1215405741
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Entity Type | Individual
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Provider Name | ALLISON MIYUKI WONG PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 11/02/2018
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Provider Practice Location Address
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Address Line | 5601 DE SOTO AVE
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6701
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Country | US
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Telephone | 866-391-2710
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Fax |
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Provider Business Mailing Address
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Address Line | 335 S ALMANSOR ST APT I
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City | ALHAMBRA
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State | CA
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Zip | 91801-4286
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Country | US
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Telephone | 510-432-6836
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 77467
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License Number State | CA
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