Provider Demographics
NPI:1023565314
Name:ANSLINGER, CHRISTOPHE THOMAS (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHE
Middle Name:THOMAS
Last Name:ANSLINGER
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 1:2488 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5508
Mailing Address - Country:US
Mailing Address - Phone:209-401-5103
Mailing Address - Fax:
Practice Address - Street 1:2488 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5508
Practice Address - Country:US
Practice Address - Phone:209-948-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-05
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA53714363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical