Active NPI
Carmen Wong, RPH
- Pharmacist
- La Mesa, CA
National Provider Identifier
1144770330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 75387
- Practice address
- 5555 Grossmont Center Dr
La Mesa, CA 91942-3019 - Phone
- (619) 740-4451
- NPI assigned
- Oct 11, 2016
- Last updated
- Jan 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 75387 | CA | Primary |
Addresses
Primary practice location
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Mailing address
2074 Campo Verde CT
Escondido, CA 92026-4016
Phone (415) 794-9332
Other practice location 1
1810 Main St
Ramona, CA 92065
Phone (760) 789-9062
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75387 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675036800000",
"number": "1144770330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2074 CAMPO VERDE CT",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920264016",
"telephone_number": "415-794-9332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 GROSSMONT CENTER DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423019",
"telephone_number": "619-740-4451"
}
],
"practiceLocations": [
{
"address_1": "1810 Main St",
"address_purpose": "LOCATION",
"city": "Ramona",
"state": "CA",
"postal_code": "92065",
"country_code": "US",
"telephone_number": "760-789-9062",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WONG",
"first_name": "CARMEN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-11",
"last_updated": "2023-01-30",
"certification_date": "2023-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "75387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.