Healthcare Provider Details

I. General information

NPI: 1396822821
Provider Name (Legal Business Name): CARSON TAHOE EMERGENCY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL PKWY
CARSON CITY NV
89703-4625
US

IV. Provider business mailing address

1600 MEDICAL PKWY
CARSON CITY NV
89703-4625
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-8005
  • Fax: 775-888-3229
Mailing address:
  • Phone: 775-445-8005
  • Fax: 775-888-3229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number06-00889
License Number StateNV

VIII. Authorized Official

Name: BRETT H EISENMESSER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 775-315-0966