Healthcare Provider Details

I. General information

NPI: 1023415726
Provider Name (Legal Business Name): CASSANDRA DORAME
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E RAY RD STE 4A
CHANDLER AZ
85225-1777
US

IV. Provider business mailing address

1050 E RAY RD STE 4A
CHANDLER AZ
85225-1777
US

V. Phone/Fax

Practice location:
  • Phone: 480-659-2000
  • Fax: 480-659-3201
Mailing address:
  • Phone: 480-659-2000
  • Fax: 480-659-3201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5940
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: