Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Michael Tillery, ATC

Individual provider Athletic Trainer · NPI 1164980694

Mr. Michael Tillery, ATC is an Athletic Trainer in Lompoc, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2019
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

4350 Constellation Rd
Lompoc, CA 93436-1033
Phone: (805) 742-2900
Fax: (895) 742-2917
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 070402516 (CA)

Record details

NPI number1164980694
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorYes
NPI enumeratedMarch 4, 2019
Last updated in NPPESMarch 4, 2019

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