Provider Demographics
NPI:1699847624
Name:WONG, HON FAI (RPH)
Entity type:Individual
Prefix:MR
First Name:HON
Middle Name:FAI
Last Name:WONG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:RONNIE
Other - Middle Name:FAI
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1495 FINEO CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-3052
Mailing Address - Country:US
Mailing Address - Phone:408-441-8744
Mailing Address - Fax:
Practice Address - Street 1:39400 PASEO PADRE PKWY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2310
Practice Address - Country:US
Practice Address - Phone:510-248-7577
Practice Address - Fax:510-248-7581
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43416183500000X
TX30577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist