Active NPI
John Tin Wang, PHARMD
- Pharmacist
- Oakland, CA
National Provider Identifier
1336624980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 79444
- Practice address
- 3550 Fruitvale Ave
Oakland, CA 94602-2327 - Phone
- (510) 530-7067
- NPI assigned
- Sep 29, 2018
- Sex
- Male
- 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 | 79444 | CA | Primary |
Addresses
Primary practice location
3550 Fruitvale Ave
Oakland, CA 94602-2327
Mailing address
57 Saint Johns CT
San Lorenzo, CA 94580-1704
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 |
|---|---|---|---|
| 79444 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538179200000",
"number": "1336624980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 SAINT JOHNS CT",
"city": "SAN LORENZO",
"state": "CA",
"postal_code": "945801704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 FRUITVALE AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946022327",
"telephone_number": "510-530-7067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "JOHN",
"middle_name": "TIN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-29",
"last_updated": "2018-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "79444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.