Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicholas William Fong, PA-C

Individual provider Physician Assistant · NPI 1205587607

Nicholas William Fong, PA-C is a Physician Assistant in Antioch, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2022
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

3901 Lone Tree Way
Antioch, CA 94509-6200
Phone: (925) 779-7273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 60749 (CA)

Record details

NPI number1205587607
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 17, 2022
Last updated in NPPESFebruary 24, 2026
Certification dateFebruary 24, 2026
Mailing address3901 Lone Tree Way, Antioch, CA 94509-6200

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