Provider Demographics
NPI:1144529173
Name:WONG, CATHY (PHARM D)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
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 1:1000 N RENGSTORFF AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-1716
Mailing Address - Country:US
Mailing Address - Phone:650-988-7160
Mailing Address - Fax:650-988-9784
Practice Address - Street 1:1000 N RENGSTORFF AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1716
Practice Address - Country:US
Practice Address - Phone:650-988-7160
Practice Address - Fax:650-988-9784
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479981835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist