Provider Demographics
NPI:1275781981
Name:LEWIS, CHRISTOPHER A (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:LEWIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 S. CENTRAL VALLEY HWY
Mailing Address - Street 2:PO BOX 1060
Mailing Address - City:SHAFTER
Mailing Address - State:CA
Mailing Address - Zip Code:93263-1347
Mailing Address - Country:US
Mailing Address - Phone:661-822-9054
Mailing Address - Fax:661-822-9082
Practice Address - Street 1:161 N MILL ST
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-1347
Practice Address - Country:US
Practice Address - Phone:661-822-9054
Practice Address - Fax:661-822-9082
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20021363A00000X
OH50.002820363A00000X
PAMA053552363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant