MEDICARE: MS. CHRISTINA MARIE TUCKER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA16237	CA

General Provider Information

NPI Number	:	1609887355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA MARIE TUCKER PA-C

Provider Business Mailing Address
First Line	:	11 GLADSTONE DR
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94112-1632
Country	:	US
Telephone Number	:	415-337-5552
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 SUTTER ST RM 1824
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-4111
Country	:	US
Telephone Number	:	415-989-9400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	06/30/2020

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