| Provider / Organization | NPI | Date Certified |
|---|---|---|
| NICOLE KONG | 1568061109 | 2020-10-24 |
Nicole Kong is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1568061109. Registration indicates Nicole Kong is a provider of services with a specialization in Pharmacy Service Providers, Pharmacist (Pharmacist, ) (Pharmacist, Pharmacy Service Providers)
| Entity Type | Individual |
| Provider Name | Nicole Kong PHARMD |
| Practice Office Address | 1600 EL CAMINO REAL SOUTH SAN FRANC, CA US |
| Practice Office Telephone | 6507573003 |
| Mailing Address | 9989 DONA NEELY WAY ELK GROVE, CA 957576436 US |
| Code | Practice | License No State |
|---|---|---|
| 183500000X PRIMARY | Pharmacy Service Providers Pharmacist Pharmacist Pharmacist Pharmacy Service Providers | 80824
CA |