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

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.

See every abbreviation used in this directory →

Practice location Address checks out

4350 Constellation Rd
Lompoc, CA 93436-1033
Phone: (805) 742-2900
Fax: (895) 742-2917
Show map & directions

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
Mailing address4350 Constellation Rd, Lompoc, CA 93436-1099

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