Provider Demographics
NPI:1861679979
Name:FUNG, WESLEY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:LEE
Last Name:FUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18370 BURBANK BLVD STE 607
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2833
Mailing Address - Country:US
Mailing Address - Phone:747-265-6252
Mailing Address - Fax:747-265-6892
Practice Address - Street 1:18370 BURBANK BLVD STE 607
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2833
Practice Address - Country:US
Practice Address - Phone:747-265-6252
Practice Address - Fax:747-265-6892
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA93327208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery