Provider Demographics
NPI:1336393974
Name:WANG, CHUNG-WEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHUNG-WEN
Middle Name:
Last Name:WANG
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 1:1700 WHEELING ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7211
Mailing Address - Country:US
Mailing Address - Phone:720-723-7140
Mailing Address - Fax:
Practice Address - Street 1:1700 WHEELING ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7211
Practice Address - Country:US
Practice Address - Phone:720-723-7140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 60355183500000X
CA603551835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist