Active NPI
Inness Man-Wing Wan, RPH
- Pharmacist
- San Dimas, CA
National Provider Identifier
1194964189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 49291
- Practice address
- 520 N Lone Hill Ave
San Dimas, CA 91773-1725 - Phone
- (909) 962-5516
- Fax
- (909) 962-5513
- NPI assigned
- Feb 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 49291 | CA | Primary |
Addresses
Primary practice location
520 N Lone Hill Ave
San Dimas, CA 91773-1725
Mailing address
520 N Lone Hill Ave
San Dimas, CA 91773-1725
Phone (909) 962-5516
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 |
|---|---|---|---|
| 49291 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234483200000",
"number": "1194964189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 N LONE HILL AVE",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917731725",
"telephone_number": "909-962-5516",
"fax_number": "909-962-5513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N LONE HILL AVE",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917731725",
"telephone_number": "909-962-5516",
"fax_number": "909-962-5513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAN",
"first_name": "INNESS",
"middle_name": "MAN-WING",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-13",
"last_updated": "2009-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "49291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Dimas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.