Active NPI
Wailan Gong, PHARMD
- Pharmacist
- Sacramento, CA
National Provider Identifier
1205406444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 49536
- Practice address
- 4860 Y St Ste 1200
Sacramento, CA 95817-2307 - Phone
- (916) 734-6789
- NPI assigned
- Jun 29, 2021
- 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 | 49536 | CA | Primary |
Addresses
Primary practice location
4860 Y St Ste 1200
Sacramento, CA 95817-2307
Mailing address
4860 Y St Ste 1200
Sacramento, CA 95817-2307
Phone (916) 734-6789
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Wgong@ucdavis.edu |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49536 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1205406444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4860 Y ST STE 1200",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172307",
"telephone_number": "916-734-6789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4860 Y ST STE 1200",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172307",
"telephone_number": "916-734-6789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONG",
"first_name": "WAILAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "49536",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Wgong@ucdavis.edu",
"affiliation": "N",
"address_1": "4860 Y St Ste 1200",
"city": "Sacramento",
"state": "CA",
"country_code": "US",
"postal_code": "958172307",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.