| Doctor Name: | DR. TRACY WONG |
| NPI Number: | 1083703268 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHARM.D. |
| License Number: | 41982 |
| Business Practice Address: | 1200 El Camino Real Medical Office Building, 4th Floor, Room 4-9965 South San Francisco, CA - 940803208 |
| Business Phone Number: | 6507422219 |
| Business Fax Number: | 6507423869 |
| Mailing Address: | 1200 El Camino Real, Medical Office Building, 4th Floor, Room 4-9965 SOUTH SAN FRANCISCO |
| State: | CA |
| Postal Code: | 940803208 |
| Phone Number: | 6507422219 |
| Fax Number: | 6507423869 |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 07/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835P0018X |
| License Number: | 41982 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Taxonomy Definition: | Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |