Active NPI
Matthew Sison Wong
- Pharmacist
- Oakland, CA
National Provider Identifier
1952180531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 85260
- Practice address
- 6 Crestmont Dr
Oakland, CA 94619-2310 - Phone
- (510) 501-4533
- NPI assigned
- Sep 25, 2023
- 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 | 85260 | CA | Primary |
Addresses
Primary practice location
6 Crestmont Dr
Oakland, CA 94619-2310
Mailing address
6 Crestmont Dr
Oakland, CA 94619-2310
Phone (510) 501-4533
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85260 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1952180531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 CRESTMONT DR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946192310",
"telephone_number": "510-501-4533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 CRESTMONT DR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946192310",
"telephone_number": "510-501-4533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISON WONG",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "85260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.