Individual provider · Type 1 NPI

Daniel Fong Jr., PA-C

Physician Assistant · Salt Lake City, UT

NPI number 1720450646 Active

Practice location

10 W Broadway Fl 7
Salt Lake City, UT 84101-2060

Call (866) 849-0692 Map

Mailing address

777 Avenue H
Powell, WY 82435-2260

Other practice locations

  • 777 Avenue H, Powell, WY 82435-2260 · (307) 754-2267
  • 424 Yellowstone Ave Ste 120, Cody, WY 82414-9311 · (307) 578-2903

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed
Physician Assistant 363A00000XPA.0004438 (CO)
Physician Assistant 363A00000X14268608-1206 (UT)
Surgical Physician Assistant 363AS0400XPA.0004438 (CO)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1720450646

Daniel Fong Jr., PA-C's National Provider Identifier is 1720450646, issued on Oct 30, 2015. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Salt Lake City, UT. The record was last updated on Feb 4, 2026.