Provider Demographics
NPI:1114177110
Name:KONG, PATSY (PHARMD)
Entity Type:Individual
Prefix:
First Name:PATSY
Middle Name:
Last Name:KONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DIVISADERO ST # H5309
Mailing Address - Street 2:BOX 1712, MZ INFUSION CENTER
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3010
Mailing Address - Country:US
Mailing Address - Phone:415-353-7053
Mailing Address - Fax:415-353-7089
Practice Address - Street 1:1600 DIVISADERO ST # H5309
Practice Address - Street 2:BOX 1712, MZ INFUSION CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3010
Practice Address - Country:US
Practice Address - Phone:415-353-7053
Practice Address - Fax:415-353-7089
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARPH564571835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology