Individual
ANDY WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 DWIGHT WAY STE 2182, BERKELEY, CA 94704-2608
(510) 204-6550
Mailing address
PO BOX 16525, SAN FRANCISCO, CA 94116-0525
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
74991
CA
Other
Enumeration date
10/17/2016
Last updated
09/27/2020
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