Provider Demographics
NPI:1902419815
Name:WONG, WING HANG VIRGINIA
Entity type:Individual
Prefix:
First Name:WING HANG VIRGINIA
Middle Name:
Last Name:WONG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1746 N MILPITAS BLVD # 2
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-2713
Mailing Address - Country:US
Mailing Address - Phone:617-459-0438
Mailing Address - Fax:
Practice Address - Street 1:1746 N MILPITAS BLVD # 2
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-2713
Practice Address - Country:US
Practice Address - Phone:617-459-0438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-29
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist