Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Daniel Fong Jr., PA-C

Individual provider Physician Assistant · NPI 1720450646

Daniel Fong Jr., PA-C is a Physician Assistant in Salt Lake City, Utah. Qualified in 2015, 11 years ago. Practices with Powell Valley Health Care Inc, a 35-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Colorado, Utah and Wyoming.

Years since qualifying
11
Licensed in
CO, UT, WY
In the registry since
2015
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10 W Broadway Fl 7
Salt Lake City, UT 84101-2060
Phone: (866) 849-0692
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (WY)
Physician Assistant Taxonomy 363A00000X · Licence PA.0004438 (CO)
Physician Assistant Taxonomy 363A00000X · Licence 14268608-1206 (UT)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA.0004438 (CO)

Record details

NPI number1720450646
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 30, 2015
Last updated in NPPESFebruary 4, 2026
Certification dateFebruary 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Powell Valley Health Care Inc — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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