Provider Demographics
NPI:1407338619
Name:CHAO, WENDY (PHARMD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CHAO
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 1:3860 MARTIN LUTHER KING JR WAY UNIT 305
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2795
Mailing Address - Country:US
Mailing Address - Phone:415-827-4777
Mailing Address - Fax:
Practice Address - Street 1:3320 FRUITVALE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-2316
Practice Address - Country:US
Practice Address - Phone:510-530-3156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist