Active NPI
Mark A Michelon
- Student in an Organized Health Care Education/Training Program
- Sacramento, CA
National Provider Identifier
1790762953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- INT17092
- Practice address
- 2800 L St
Suite 450
Sacramento, CA 95816-5616 - Phone
- (916) 454-6744
- NPI assigned
- Dec 29, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | INT17092 | CA | Primary |
Addresses
Primary practice location
2800 L St
Suite 450
Sacramento, CA 95816-5616
Mailing address
2210 I St
Apt. 2a
Sacramento, CA 95816-4070
Phone (916) 444-2381
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 |
|---|---|---|---|
| INT17092 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Health Sacramento Sierra Region | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Long Term Care Pharmacy
- Sacramento, CA
- NPI 1295893121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790762953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2210 I ST",
"address_2": "APT. 2A",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958164070",
"telephone_number": "916-444-2381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 L ST",
"address_2": "SUITE 450",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165616",
"telephone_number": "916-454-6744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELON",
"first_name": "MARK",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "INT17092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.