Active NPI
Kelly Wong, PHARM D
- Pharmacist
- Colton, CA
National Provider Identifier
1992176259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH40823
- Practice address
- 1120 S NT Vernon Ave
Colton, CA 92324 - Phone
- (909) 783-0390
- NPI assigned
- Oct 13, 2015
- Sex
- Female
- 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 | RPH40823 | CA | Primary |
Addresses
Primary practice location
1120 S NT Vernon Ave
Colton, CA 92324
Mailing address
10871 Carriage Dr
Alta Loma, CA 91737
Phone (909) 921-8492
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH40823 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1992176259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10871 CARRIAGE DR",
"city": "ALTA LOMA",
"state": "CA",
"postal_code": "91737",
"telephone_number": "909-921-8492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 S NT VERNON AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "92324",
"telephone_number": "909-783-0390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "KELLY",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-13",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH40823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.