Healthcare Provider Details

I. General information

NPI: 1215817960
Provider Name (Legal Business Name): ANDREW MUELLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 E KASHIAN LN STE 450
FRESNO CA
93701-2234
US

IV. Provider business mailing address

PO BOX 889442
LOS ANGELES CA
90088-9442
US

V. Phone/Fax

Practice location:
  • Phone: 559-233-7700
  • Fax: 559-233-7744
Mailing address:
  • Phone: 559-603-7372
  • Fax: 559-451-3661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGC001990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: