MEDICARE: RYAN 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
1	183500000X	Pharmacist	PH-3569	HI

General Provider Information

NPI Number	:	1891203022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN WONG PHARMD

Provider Business Mailing Address
First Line	:	45-480 KANEOHE BAY DR
Second Line	:
City	:	KANEOHE
State	:	HI
Zip	:	96744-2039
Country	:	US
Telephone Number	:	808-235-5805
Fax Number	:

Provider Business Practice Location Address
First Line	:	45-480 KANEOHE BAY DR
Second Line	:
City	:	KANEOHE
State	:	HI
Zip	:	96744-2039
Country	:	US
Telephone Number	:	808-235-5805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2018
Last Update Date	:	06/18/2020

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Directions to “ RYAN WONG PHARMD” Practice Location

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