Provider Demographics
NPI:1538390364
Name:WONG, JONATHAN CALVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CALVIN
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 1:1660 PAULA DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-4316
Mailing Address - Country:US
Mailing Address - Phone:415-286-6949
Mailing Address - Fax:
Practice Address - Street 1:4150 CLEMENT STREET (119)
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-6603
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist