Elton Y. Wong

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY38028 Issued in CA

Legal business name

ELTON Y. WONG

Practice address

719 E 12TH St
Oakland, CA 94606-3624

Phone

(510) 839-8839

Fax

(510) 839-8696

NPI assigned

Aug 29, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Elton Y Wong, PHARM D

Title

Owner

Phone

(510) 839-8839

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• New Chinatown Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1649263302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 E 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946063624",
            "telephone_number": "510-839-8839",
            "fax_number": "510-839-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 E 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946063624",
            "telephone_number": "510-839-8839",
            "fax_number": "510-839-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELTON Y. WONG",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "ELTON",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-839-8839",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY38028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0579447",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA380280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Chinatown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Oakland, CA
• Providers in Oakland, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.