Individual provider Active NPI

Shinmann Wang, PHARMD

  • Pharmacist
  • Diamond Bar, CA
National Provider Identifier
1891081691
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
60359 Issued in CA
Practice address
747 Grand Ave
Target Pharmacy (T2179)
Diamond Bar, CA 91765-8400
Phone
(909) 610-2150
Fax
(909) 610-2150
NPI assigned
Jun 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 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 60359 CA Primary

Addresses

Primary practice location

747 Grand Ave
Target Pharmacy (T2179)
Diamond Bar, CA 91765-8400

Mailing address

747 Grand Ave
Target Pharmacy (T2179)
Diamond Bar, CA 91765-8400
Phone (909) 610-2150

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
60359CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1891081691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 GRAND AVE",
            "address_2": "TARGET PHARMACY (T2179)",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917658400",
            "telephone_number": "909-610-2150",
            "fax_number": "909-610-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 GRAND AVE",
            "address_2": "TARGET PHARMACY (T2179)",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917658400",
            "telephone_number": "909-610-2150",
            "fax_number": "909-610-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SHINMANN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "60359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

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