Provider Demographics
NPI:1114006624
Name:WONG, WING TUNG JOYCE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:WING TUNG
Middle Name:JOYCE
Last Name:WONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2948 VETERAN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4121
Mailing Address - Country:US
Mailing Address - Phone:310-801-3671
Mailing Address - Fax:
Practice Address - Street 1:9036 ARCADIA AVE APT 55
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1459
Practice Address - Country:US
Practice Address - Phone:626-292-1338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist