Healthcare Provider Details

I. General information

NPI: 1033423579
Provider Name (Legal Business Name): KRISTINE ANIDO GARCIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROSARY KRISTINE ISIDRO ANIDO MD

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 W HERNDON AVE STE 108
FRESNO CA
93722-8401
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-256-7990
  • Fax: 559-256-7991
Mailing address:
  • Phone: 559-353-5700
  • Fax: 559-353-5708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC192564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: