Individual provider · Type 1 NPI

Mark Alan Tilley, PA-C

Surgical Physician Assistant · Woodland, CA

NPI number 1720177884 Active

Practice location

2081 Bronze Star Dr
Woodland, CA 95776-5423

Call (530) 668-2600 Map

Fax (530) 661-1081

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA22733 (CA)
Surgical Physician Assistant Primary 363AS0400XPA22733 (CA)

Surgical Physician Assistant: Definition to come...

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About NPI 1720177884

Mark Alan Tilley, PA-C's National Provider Identifier is 1720177884, issued on Oct 12, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Woodland, CA. The record was last updated on Nov 28, 2022.