Provider Demographics
NPI:1891914685
Name:WONG, DARREN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:
Last Name:WONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 W ORIOLE WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-3264
Mailing Address - Country:US
Mailing Address - Phone:480-899-5681
Mailing Address - Fax:
Practice Address - Street 1:7333 S HARDY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-4478
Practice Address - Country:US
Practice Address - Phone:602-477-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist