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NPI Code Detail

MEDICARE: DR. JOHN F WONG PHARMD

MEDICARE:  DR. JOHN F WONG  PHARMD
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
1183500000XPharmacist52583CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
152583OTHERCACALIFORNA LICENSE NUMBER

General Provider Information

NPI Number : 1720068828
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN F WONG PHARMD
Provider Business Mailing Address
First Line : 1108 WARD AVE
Second Line : PO BOX 43, BLDG B, SUITE #6
City : PATTERSON
State : CA
Zip : 95363-0043
Country : US
Telephone Number : 209-892-8444
Fax Number : 209-892-8472
Provider Business Practice Location Address
First Line : 1108 WARD AVE
Second Line : BLDG B SUITE #6
City : PATTERSON
State : CA
Zip : 95363-8529
Country : US
Telephone Number : 209-892-8444
Fax Number : 209-892-8472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN F WONG PHARMD” Practice Location

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