Healthcare Provider Details

I. General information

NPI: 1083773170
Provider Name (Legal Business Name): CASANDRA ANDERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7130 N MILLBROOK AVE
FRESNO CA
93720-3347
US

IV. Provider business mailing address

PO BOX 25100
FRESNO CA
93729-5100
US

V. Phone/Fax

Practice location:
  • Phone: 559-326-1222
  • Fax: 559-326-1230
Mailing address:
  • Phone: 559-326-1222
  • Fax: 559-326-1230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA95564
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number45181
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: