Provider Demographics
NPI:1083990980
Name:WONG, CINDY S (PHARM D)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:S
Last Name:WONG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8218 SUNSET ROSE DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-7317
Mailing Address - Country:US
Mailing Address - Phone:626-215-1126
Mailing Address - Fax:951-286-4931
Practice Address - Street 1:38995 SKY CANYON DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2617
Practice Address - Country:US
Practice Address - Phone:951-677-6375
Practice Address - Fax:951-677-6982
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist