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General NPI Number Information
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NPI Number | 1295319986
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Entity Type | Individual
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Provider Name | MICHAEL YOUNG ALLEN PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/08/2021
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 5070 ION DR STE 100
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City | SPARKS
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State | NV
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Zip | 89436-1654
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Country | US
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Telephone | 775-770-7682
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Fax | 775-770-7755
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Provider Business Mailing Address
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Address Line | 6555 OGLALA CT
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City | SUN VALLEY
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State | NV
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Zip | 89433-6643
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Country | US
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Telephone | 775-530-1510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2737
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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