Provider Demographics
NPI:1417019324
Name:VELEZ, ANGELA WONG (PHARMD, CDE)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:WONG
Last Name:VELEZ
Suffix:
Gender:F
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11080 MAGNOLIA AVE
Mailing Address - Street 2:PHARMACY ADMINISTRATION
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3047
Mailing Address - Country:US
Mailing Address - Phone:951-602-4108
Mailing Address - Fax:
Practice Address - Street 1:11080 MAGNOLIA AVE
Practice Address - Street 2:PHARMACY ADMINISTRATION
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3047
Practice Address - Country:US
Practice Address - Phone:951-602-4108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH54024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist