Wilson Fung, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G069969 Issued in CA

Practice address

2438 N Ponderosa Dr
BLDG C-101
Camarillo, CA 93010-2369

Phone

(804) 484-1190

Fax

(805) 764-0176

NPI assigned

Nov 16, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wilson Fung MD Inc

  dba Wilson Fung Md

  • General Practice Physician
  • Camarillo, CA
  • NPI 1154613024
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942282819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2438 N PONDEROSA DR",
            "address_2": "BLDG C 101",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102369",
            "telephone_number": "805-484-1190",
            "fax_number": "805-764-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2438 N PONDEROSA DR",
            "address_2": "BLDG C-101",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102369",
            "telephone_number": "804-484-1190",
            "fax_number": "805-764-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "WILSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G069969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresh & Fabulous, Inc. (Fresh & Fabulous)
• Stephanie Friedman
• Johnny Frugoli
• Jenny Fuentes, LVN
• Laura Fuld, R.D.
• Liz Cabanes Gahit, PMHNP-BC
• Arthur Galaviz
• Galen Inpatient Physicians PC
• Arlene Georgia Gallan, PHD
• Edith Gallardo

• Family Medicine Physician in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.