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General NPI Number Information
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NPI Number | 1932470259
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Entity Type | Individual
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Provider Name | SHUK MAN ANNIE WONG PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 8080 PARKWAY DR
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City | LA MESA
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State | CA
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Zip | 91942-2104
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Country | US
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Telephone | 619-589-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 5429 ESCARCHOSA LN
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City | SAN DIEGO
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State | CA
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Zip | 92124-1823
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Country | US
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Telephone | 858-531-8898
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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 | 65733
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License Number State | CA
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