Healthcare Provider Details

I. General information

NPI: 1841290798
Provider Name (Legal Business Name): BRIAN D EVANS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10121 PINE AVE
TRUCKEE CA
96161-4835
US

IV. Provider business mailing address

10121 PINE AVE
TRUCKEE CA
96161-4835
US

V. Phone/Fax

Practice location:
  • Phone: 530-587-6011
  • Fax: 530-582-1864
Mailing address:
  • Phone: 530-587-6011
  • Fax: 530-582-1864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA67869
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA67869
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: