Healthcare Provider Details

I. General information

NPI: 1275781981
Provider Name (Legal Business Name): CHRISTOPHER A LEWIS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 N MILL ST
TEHACHAPI CA
93561-1347
US

IV. Provider business mailing address

659 S. CENTRAL VALLEY HWY PO BOX 1060
SHAFTER CA
93263-1347
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-9054
  • Fax: 661-822-9082
Mailing address:
  • Phone: 661-822-9054
  • Fax: 661-822-9082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20021
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.002820
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA053552
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: