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NPI Code Detail

MEDICARE: DR. STACEY LEE BROWN MD

MEDICARE: DR. STACEY LEE BROWN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA54711CA

General Provider Information

NPI Number : 1629004650
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STACEY LEE BROWN MD
Provider Business Mailing Address
First Line : 940 STARLITE DR
Second Line :
City : BISHOP
State : CA
Zip : 93514-7027
Country : US
Telephone Number : 760-873-2849
Fax Number : 866-610-0738
Provider Business Practice Location Address
First Line : 150 PIONEER LN
Second Line :
City : BISHOP
State : CA
Zip : 93514-2556
Country : US
Telephone Number : 760-920-0520
Fax Number : 760-873-2897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 08/27/2025

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Directions to “ DR. STACEY LEE BROWN MD” Practice Location

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