WILSON FUNG MD INC (NPI# 1154613024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154613024 |
| Entity Type | Organization |
| Organization Name | WILSON FUNG MD INC |
| Other Organization Name | WILSON FUNG MD |
| Practice Address |
2412 N Ponderosa Dr B103 Camarillo CA 93010-2373 |
| Practice Telephone | 8054841190 |
| Practice Fax Number | 8054841154 |
| Mailing Telephone | 8054841190 |
| Mailing Fax Number | 8054841154 |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2011-05-10 |
| Authorized Official Name | HOLLY LANDIS (OFFICE MANAGER) |
| Authorized Official Telephone | 8054841190 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | G69969 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Wilson Fung Md | Doing Business As Name - Organization |
| Street Address |
2412 N PONDEROSA DR B103 |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93010-2373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053314724 | Cristina N. Porch-curren | Specialist | 2412 N Ponderosa Dr, Ste B111, Camarillo, CA 93010-2379 | 2005-05-24 |
| 1144617051 | S&s Healthcare LLC | Pharmacist | 2412 N Ponderosa Dr, B106, Camarillo, CA 93010-2373 | 2015-04-17 |
| 1396781894 | Allergy Care Center A Medical Corporation | Specialist | 2412 N Ponderosa Dr, Suite B111, Camarillo, CA 93010-2373 | 2006-06-22 |
| 1255312989 | Julie Kathleen Mccardell | Nurse Practitioner | 2412 N Ponderosa Dr, B203, Camarillo, CA 93010-2373 | 2005-11-09 |
| 1013910827 | Lewis J. Kanter | Specialist | 2412 N Ponderosa Dr, Ste B111, Camarillo, CA 93010-2379 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261366 | Edith Gallardo | Behavior Technician | 400 Mobile Avenue Suite A-3, Camarillo, CA 93010 | 2020-10-05 |
| 1568094761 | Amanda Montoya | Physical Therapist | 58 Calle Escalon, Camarillo, CA 93010 | 2020-02-06 |
| 1518509678 | Esther Marie Brown Gonzalez | Technician | 2826 Munson St, Camarilla, CA 93010 | 2019-10-10 |
| 1023666385 | Nancy Monetta Wigert | Speech-Language Pathologist | 155 Granada Street #a, Camarillo, CA 93010 | 2019-08-29 |
| 1174098651 | Tatianna Kraft | Counselor | 4243 Vincente Ave, Camarillo, CA 93010 | 2018-10-10 |
| 1861977662 | Marina Wischnack | Psychologist | 1200 Paseo Camarillo, Suite 245, Camarillo, CA 93010 | 2018-09-27 |
| 1417430620 | Peter Lawrence Mcdermott | Anesthesiology | 141 Lapatera Drive, Camarillo, CA 93010 | 2018-09-13 |
| 1689162521 | Mehgan Lynn Lambert | Specialist | 333 Skyway Drive, Camarillo, CA 93010 | 2018-04-26 |
| 1134643208 | Hailey Kay Kohler | Social Worker | 692 Spring Oak Road Unit 721, Camarillo, CA 93010 | 2017-08-01 |
| 1174052369 | Demi Shugrue | Counselor | 2021 Sperry Ave, Suite 37, Ventura, CA 93010 | 2017-06-09 |
| Find all providers in zip 93010 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1669464715 | Camarillo Springs Holistic Medical | General Practice | 816 Camarillo Springs Rd, #e, Camarillo, CA 93012-9441 | 2005-08-16 |
| 1659673382 | Hung Vu Do | General Practice | 3100 Wright Rd, Camarillo, CA 93010-8307 | 2010-12-01 |
| 1205024130 | Thomas R. Phelps, M.d., Inc. | General Practice | 2275 Las Posas Rd, Camarillo, CA 93010-3344 | 2007-10-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.