Provider Demographics
NPI:1821094855
Name:BROWN, DEBORAH ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10956 DONNER PASS RD
Mailing Address - Street 2:STE 130
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-4860
Mailing Address - Country:US
Mailing Address - Phone:530-587-3523
Mailing Address - Fax:530-587-1004
Practice Address - Street 1:10956 DONNER PASS RD
Practice Address - Street 2:STE 130
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4860
Practice Address - Country:US
Practice Address - Phone:530-587-3523
Practice Address - Fax:530-587-1004
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC043230208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0075020Medicaid
CA260026968OtherTAX IDENTIFICATION NUMBER
CAZHCPP486OtherBLUE CROSS OF CALIFORNIA
CAZZZ52949ZOtherBLUE SHIELD OF CALIFORNIA