Individual
MARK ALAN TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2081 BRONZE STAR DR, WOODLAND, CA 95776-5423
(530) 668-2600
(530) 661-1081
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA22733
CA
363AS0400X
Surgical Physician Assistant
Primary
PA22733
CA
Other
Enumeration date
10/12/2006
Last updated
11/28/2022
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