Individual provider Active NPI

Victor Wong, PHARM.D.

  • Pharmacist
  • Walnut Creek, CA
National Provider Identifier
1528590973
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
30984 Issued in CA
Practice address
2880 Shadelands Dr
Suite 201
Walnut Creek, CA 94598-2522
Phone
(925) 979-6824
NPI assigned
Apr 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 30984 CA Primary

Addresses

Primary practice location

2880 Shadelands Dr
Suite 201
Walnut Creek, CA 94598-2522

Mailing address

2880 Shadelands Dr
Suite 201
Walnut Creek, CA 94598-2522
Phone (925) 979-6824

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

LicenseStateTypeSpecialty
30984CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1528590973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 SHADELANDS DR",
            "address_2": "SUITE 201",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982522",
            "telephone_number": "925-979-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 SHADELANDS DR",
            "address_2": "SUITE 201",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982522",
            "telephone_number": "925-979-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "VICTOR",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "30984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.