Michael Young Allen, PA-C
Individual provider Active NPI Physician Assistant · Sparks, NV
NPI 1295319986 · NPPES record last updated May 2, 2023
Key facts
- NPI
- 1295319986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2737 (NV)
- Practice address
- 5070 Ion Dr Ste 100
Sparks, NV 89436-1654 - Phone
- (775) 770-7682
- Fax
- (775) 770-7755
- NPI assigned
- May 8, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2737 | NV | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2737 | NV | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
5070 Ion Dr Ste 100
Sparks, NV 89436-1654
Mailing address
6555 Oglala CT
Sun Valley, NV 89433-6643
Phone (775) 530-1510
Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.