Active NPI
Michael Alan Page
- Pharmacist
- Roseville, CA
National Provider Identifier
1316411960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39413
- Practice address
- 5090 Foothills Blvd
Roseville, CA 95747-6517 - Phone
- (916) 783-1355
- Fax
- (916) 783-1360
- NPI assigned
- Jan 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 39413 | CA | Primary |
Addresses
Primary practice location
5090 Foothills Blvd
Roseville, CA 95747-6517
Mailing address
5090 Foothills Blvd
Roseville, CA 95747-6517
Phone (916) 783-1355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39413 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | Past | Accepting new patients | |
| Longs Drug Stores California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1316411960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5090 FOOTHILLS BLVD",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "957476517",
"telephone_number": "916-783-1355",
"fax_number": "916-783-1360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5090 FOOTHILLS BLVD",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "957476517",
"telephone_number": "916-783-1355",
"fax_number": "916-783-1360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "MICHAEL",
"middle_name": "ALAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "39413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.