IndividualActive
Christopher Waller, IDC
NPI 1871850321 · Physician Assistant · Fallon, NV
Provider details
- NPI number
- 1871850321
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- Yes
Practice location
4755 Pasture Rd Bldg 299
Fallon, NV 89496-3202
Phone: (775) 426-3125
Fax: (775) 426-3135
Mailing address
937 Franklin Blvd
Lemoore, CA 93246-4700
Registry dates
- Enumerated
- 2012-04-20
- Last updated
- 2024-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.