Provider Demographics
NPI:1184021966
Name:ONG, SEA KAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:SEA KAN
Middle Name:
Last Name:ONG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10202 W SILVER SPRING DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-3265
Mailing Address - Country:US
Mailing Address - Phone:414-461-1428
Mailing Address - Fax:414-461-1731
Practice Address - Street 1:10202 W SILVER SPRING DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-3265
Practice Address - Country:US
Practice Address - Phone:414-461-1428
Practice Address - Fax:414-461-1731
Is Sole Proprietor?:No
Enumeration Date:2014-11-22
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11765-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist