Individual provider Active NPI

Ling Yi Wang, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Orange, CA
National Provider Identifier
1790063055
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
44058 Issued in CA
Practice address
1201 W la Veta Ave
Orange, CA 92868-4203
Phone
(714) 509-4047
Fax
(714) 509-4371
NPI assigned
Aug 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 44058 CA Primary

Addresses

Primary practice location

1201 W la Veta Ave
Orange, CA 92868-4203

Mailing address

20 Marysville
Irvine, CA 92602-1066
Phone (714) 926-6204

Other practice location 1

3030 Harbor Blvd
T-1293
Costa Mesa, CA 92626-2562
Phone (714) 979-6743

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
44058CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1790063055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MARYSVILLE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021066",
            "telephone_number": "714-926-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-4047",
            "fax_number": "714-509-4371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Harbor Blvd",
            "address_2": "T-1293",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926262562",
            "country_code": "US",
            "telephone_number": "714-979-6743",
            "fax_number": "714-979-6743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "LING",
        "middle_name": "YI",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "44058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.