Individual provider Active NPI

Nora Louie Wong, PHARM D

  • Pharmacist
  • San Rafael, CA
National Provider Identifier
1750668430
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28239 Issued in CA
Practice address
442 Las Gallinas Ave
San Rafael, CA 94903-3618
Phone
(415) 479-9171
NPI assigned
Nov 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28239 CA Primary

Addresses

Primary practice location

442 Las Gallinas Ave
San Rafael, CA 94903-3618

Mailing address

442 Las Gallinas Ave
San Rafael, CA 94903-3618
Phone (415) 479-9171

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
28239CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Store California LLC Past Accepting new patients
Longs Drug Stores California LLC Past Accepting new patients

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": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1750668430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 LAS GALLINAS AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033618",
            "telephone_number": "415-479-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 LAS GALLINAS AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033618",
            "telephone_number": "415-479-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "NORA",
        "middle_name": "LOUIE",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "28239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.