Active NPI
Queenie Hip Ying Wan, PHARMD
- Pharmacotherapy Pharmacist
- Cerritos, CA
National Provider Identifier
1366910325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 79209
- Practice address
- 13059 Hedda LN
Cerritos, CA 90703-6145 - Phone
- (562) 565-4672
- NPI assigned
- Nov 7, 2018
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 79209 | CA | Primary |
Addresses
Primary practice location
13059 Hedda LN
Cerritos, CA 90703-6145
Mailing address
13059 Hedda LN
Cerritos, CA 90703-6145
Phone (562) 565-4672
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541548800000",
"number": "1366910325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13059 HEDDA LN",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907036145",
"telephone_number": "562-565-4672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13059 HEDDA LN",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907036145",
"telephone_number": "562-565-4672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAN",
"first_name": "QUEENIE",
"middle_name": "HIP YING",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-07",
"last_updated": "2018-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "CA",
"license": "79209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.