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General NPI Number Information
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NPI Number | 1033170634
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Entity Type | Individual
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Provider Name | DANIEL T. FANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 3811 E BELL RD STE 300
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City | PHOENIX
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State | AZ
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Zip | 85032-2160
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Country | US
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Telephone | 480-454-7350
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Fax | 602-482-2874
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Provider Business Mailing Address
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Address Line | 3811 E BELL RD STE 300
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City | PHOENIX
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State | AZ
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Zip | 85032-2160
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Country | US
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Telephone | 480-454-7350
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Fax | 602-482-2874
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 267271-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 30861
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License Number State | AZ
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