Active NPI
Edlen Wong, PHARM.D.
- Pharmacist
- Walnut Creek, CA
National Provider Identifier
1659670537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 60062
- Practice address
- 2880 Shadelands Dr
Suite 201
Walnut Creek, CA 94598-2522 - Phone
- (925) 979-6856
- NPI assigned
- Mar 18, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 60062 | 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) 979-6856
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60062 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444348800000",
"number": "1659670537",
"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": "925-979-6856"
},
{
"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": "925-979-6856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "EDLEN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-18",
"last_updated": "2015-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "60062",
"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 Oct 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.