Individual provider Active NPI

Austin Wang, PHARMD

  • Pharmacist
  • San Jose, CA
National Provider Identifier
1619418142
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60676756 Issued in WA
Practice address
2350 McKee Rd Ste A3
San Jose, CA 95116-1617
Phone
(408) 923-8871
Fax
(408) 259-4416
NPI assigned
Mar 16, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60676756 WA Primary

Addresses

Primary practice location

2350 McKee Rd Ste A3
San Jose, CA 95116-1617

Mailing address

1598 Wharton Rd
San Jose, CA 95132-2075
Phone (408) 772-0506

Other practice location 1

4025 Delridge Way SW
Seattle, WA 98106-1249
Phone (408) 772-0506

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
PH60676756WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
McKee Medical Pharmacy Inc CurrentSince Aug 9, 2020 Accepting new patients
McKee Medical Pharmacy Inc CurrentSince Aug 9, 2020 Accepting new patients

Locations

2350 McKee Rd
Ste A3
San Jose, CA 95116
Phone (408) 923-8871

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1619418142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 WHARTON RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322075",
            "telephone_number": "408-772-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MCKEE RD STE A3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161617",
            "telephone_number": "408-923-8871",
            "fax_number": "408-259-4416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4025 Delridge Way SW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981061249",
            "country_code": "US",
            "telephone_number": "408-772-0506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "AUSTIN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-16",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60676756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.