Provider Demographics
NPI:1629357546
Name:WONG, WILLIAM WAH (PHARM, D)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:WAH
Last Name:WONG
Suffix:
Gender:M
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:PO BOX 2631
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94017-2631
Mailing Address - Country:US
Mailing Address - Phone:626-372-1070
Mailing Address - Fax:
Practice Address - Street 1:1057 EASTSHORE HWY
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94710-1011
Practice Address - Country:US
Practice Address - Phone:510-982-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist