Healthcare Provider Details

I. General information

NPI: 1427453240
Provider Name (Legal Business Name): CHRISTOPHER THOMAS TOBIAS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4536 SPRUCE STREET GROUND FLOOR
PHILADELPHIA PA
19139
US

IV. Provider business mailing address

4536 SPRUCE STREET GROUND FLOOR
PHILADELPHIA PA
19139
US

V. Phone/Fax

Practice location:
  • Phone: 215-474-6100
  • Fax: 215-474-6123
Mailing address:
  • Phone: 215-474-6100
  • Fax: 215-474-6123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA057197
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: