Provider Demographics
NPI:1689739336
Name:NG, WILLIAM (PHARM D)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2500 MERCED ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4201
Mailing Address - Country:US
Mailing Address - Phone:510-454-1000
Mailing Address - Fax:510-784-2039
Practice Address - Street 1:2500 MERCED ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4201
Practice Address - Country:US
Practice Address - Phone:510-454-1000
Practice Address - Fax:510-784-2039
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist