Edmund Kong, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

85417 Issued in CA

Practice address

7299 Laguna Blvd
Elk Grove, CA 95758-5059

Phone

(916) 691-4412

NPI assigned

Oct 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Elk Grove, CA
  • NPI 1326054701
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1801559471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15367 FARNSWORTH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945792040",
            "telephone_number": "510-508-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7299 LAGUNA BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585059",
            "telephone_number": "916-691-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "EDMUND",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "85417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Ann Knight, MA, LMFT 48858
• Stella Knowlton
• Nancy Kodish
• Jamie Kofoed
• Spien Ghar Komak, BS, MD
• Sarah Kong
• Kirsten Alexis Konkel, M.S., CCC-SLP
• Christiana S Kopf, M.D.
• Benjamin Andrew Kordusky, DDS, MS
• Samantha Paola Korhummel

• Pharmacist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.