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NPI Code Detail

MEDICARE: EUGENE K WONG PHARM. D

MEDICARE: EUGENE K WONG PHARM. D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist53479CA

General Provider Information

NPI Number : 1518236728
Entity Type Code : Individual
Provider Name (Legal Business Name) : EUGENE K WONG PHARM. D
Provider Business Mailing Address
First Line : 1344 W REDONDO BEACH BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90247-3356
Country : US
Telephone Number : 310-353-5726
Fax Number : 310-353-5770
Provider Business Practice Location Address
First Line : 1344 W REDONDO BEACH BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90247-3356
Country : US
Telephone Number : 310-353-5726
Fax Number : 310-353-5770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2011
Last Update Date : 12/16/2011

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Directions to “ EUGENE K WONG PHARM. D” Practice Location

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