Active NPI
Matthew Doc Ming Wong
- Pharmacist
- Galt, CA
National Provider Identifier
1255749222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64389
- Practice address
- 10470 Twin Cities Rd
Galt, CA 95632-9032 - Phone
- (209) 744-1965
- NPI assigned
- Jul 23, 2014
- Last updated
- Jul 23, 2014
- Sex
- Male
- 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 | 64389 | CA | Primary |
Addresses
Primary practice location
10470 Twin Cities Rd
Galt, CA 95632-9032
Mailing address
10470 Twin Cities Rd
Galt, CA 95632-9032
Phone (209) 744-1965
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64389 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | 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": "1406073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1255749222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 TWIN CITIES RD",
"city": "GALT",
"state": "CA",
"postal_code": "956329032",
"telephone_number": "209-744-1965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10470 TWIN CITIES RD",
"city": "GALT",
"state": "CA",
"postal_code": "956329032",
"telephone_number": "209-744-1965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "MATTHEW",
"middle_name": "DOC MING",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-23",
"last_updated": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "64389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galt, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.