Healthcare Provider Details

I. General information

NPI: 1386633782
Provider Name (Legal Business Name): CHRISTOPHER JASON HILTON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7232 ELLEN LANE
FORESTVILLE CA
95436
US

IV. Provider business mailing address

PO BOX 178
FORESTVILLE CA
95436-0178
US

V. Phone/Fax

Practice location:
  • Phone: 707-887-2534
  • Fax: 707-887-2534
Mailing address:
  • Phone: 415-310-9089
  • Fax: 707-887-2534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA 2149
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024166626
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR127867
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: