# WILSON FUNG MD INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wilson Fung Md
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154613024
- **Authorized official:** HOLLY LANDIS (OFFICE MANAGER)
- **Authorized official phone:** (805) 484-1190

## Contact information

- **Practice address:** 2412 N PONDEROSA DR, B103, CAMARILLO, CA 93010-2373
- **Practice address phone:** (805) 484-1190
- **Practice address fax:** (805) 484-1154
- **Mailing address:** 2412 N PONDEROSA DR, B103, CAMARILLO, CA 93010-2373
- **Mailing address phone:** (805) 484-1190
- **Mailing address fax:** (805) 484-1154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | G69969 | CA | Yes |

## Other

- **Enumeration date:** 05/10/2011
- **Last updated:** 05/10/2011