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General NPI Number Information
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NPI Number | 1598699472
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Entity Type | Organization
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Legal Business Name | EARLY LIGHT PHARMACY LLC
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 1746 N MILPITAS BLVD # 2
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City | MILPITAS
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State | CA
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Zip | 95035-2713
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Country | US
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Telephone | 408-780-2882
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Fax |
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Provider Business Mailing Address
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Address Line | 1746 N MILPITAS BLVD # 2
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City | MILPITAS
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State | CA
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Zip | 95035-2713
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WING HANG VIRGINIA WONG
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Credential |
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Telephone | 408-780-2882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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