Wilson Fung MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G69969 Issued in CA

Legal business name

WILSON FUNG MD INC

Doing business as

Wilson Fung Md

Practice address

2412 N Ponderosa Dr
B103
Camarillo, CA 93010-2373

Phone

(805) 484-1190

Fax

(805) 484-1154

NPI assigned

May 10, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Holly Landis

Title

Office Manager

Phone

(805) 484-1190

Specialties & licenses 1

Addresses

Other names 1

• Wilson Fung Md Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wilson Fung, MD

  • Family Medicine Physician
  • Camarillo, CA
  • NPI 1942282819
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1154613024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 N PONDEROSA DR",
            "address_2": "B103",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102373",
            "telephone_number": "805-484-1190",
            "fax_number": "805-484-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 N PONDEROSA DR",
            "address_2": "B103",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102373",
            "telephone_number": "805-484-1190",
            "fax_number": "805-484-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON FUNG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "LANDIS",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "805-484-1190"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G69969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson Fung Md",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linse Noel Williams, BA IBCLC
• Michelle Lee Williams, LMFT
• Tanya Williams
• David Willner
• Breanne Ashley Willson, PT, DPT
• Andrew Wilson, O.D.
• Emily Wilson, LMFT
• Katherine Wilson
• Charlene Win
• Angelina Winkler

• General Practice Physician in Camarillo, CA
• Providers in Camarillo, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.