MEDICARE: DR. CHRISTOPHER EDWARD TILTON D.H.SC, 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
2	363AM0700X	Medical Physician Assistant	PA20392	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669462552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER EDWARD TILTON D.H.SC, PA-C

Provider Business Mailing Address
First Line	:	1800 N CALIFORNIA ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-6019
Country	:	US
Telephone Number	:	209-467-6166
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 N CALIFORNIA ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-6019
Country	:	US
Telephone Number	:	209-467-6166
Fax Number	:

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	01/03/2022

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