Provider Demographics
NPI:1205111879
Name:LAW, WING CHUEN FARADAY (RPH)
Entity type:Individual
Prefix:MR
First Name:WING CHUEN
Middle Name:FARADAY
Last Name:LAW
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 1:2950 N FOWLER WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-9148
Mailing Address - Country:US
Mailing Address - Phone:559-291-7589
Mailing Address - Fax:559-291-7595
Practice Address - Street 1:2950 N FOWLER WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-9148
Practice Address - Country:US
Practice Address - Phone:559-291-7589
Practice Address - Fax:559-291-7595
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44604183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist