Keldon Kyle Wong, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

62362 Issued in CA

Practice address

19105 Golden Valley Rd
Santa Clarita, CA 91387-1428

Phone

(661) 977-5155

Fax

(661) 977-5165

NPI assigned

Jul 7, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1598052755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19105 GOLDEN VALLEY RD",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913871428",
            "telephone_number": "661-977-5155",
            "fax_number": "661-977-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19105 GOLDEN VALLEY RD",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913871428",
            "telephone_number": "661-977-5155",
            "fax_number": "661-977-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KELDON",
        "middle_name": "KYLE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "45610",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "62362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tommy Woodard, P.D.
• Jaclyn Wright
• Shirong Wu, L.AC.
• Amy L Wunsch, MSPT

• Pharmacist in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.