Provider Demographics
NPI:1740451723
Name:WILLIAMS, BONNIE WONG (PHARMD)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:WONG
Last Name:WILLIAMS
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 1:6860 AVENIDA ENCINAS
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3201
Mailing Address - Country:US
Mailing Address - Phone:760-931-4228
Mailing Address - Fax:760-931-4233
Practice Address - Street 1:6860 AVENIDA ENCINAS
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-3201
Practice Address - Country:US
Practice Address - Phone:760-931-4228
Practice Address - Fax:760-931-4233
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT48907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist