Provider Demographics
NPI:1063468148
Name:TOUW, MICHELLE L (PA)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:L
Last Name:TOUW
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 48TH ST STE 2120
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1538
Mailing Address - Country:US
Mailing Address - Phone:916-734-2771
Mailing Address - Fax:916-452-2112
Practice Address - Street 1:2450 48TH ST STE 2120
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1538
Practice Address - Country:US
Practice Address - Phone:916-734-2771
Practice Address - Fax:916-452-2112
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840770363A00000X
CA58106363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8101074Medicaid
VAPAROtherMULTIPLAN
VAPAROtherCORVEL
VA-004OtherTRICARE/CHAMPUS
VA1063468148Medicaid
VA10068427POtherOPTIMA HEALTH
VAPAROtherUSA MANAGED CARE
VAPAROtherMULTIPLAN
VAVAA104472Medicare PIN