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General NPI Number Information
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NPI Number | 1679624191
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Entity Type | Individual
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Provider Name | ANDRE MARTIN KASKO D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 57445 29 PALMS HWY SUITE 301
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City | YUCCA VALLEY
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State | CA
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Zip | 92284-2947
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Country | US
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Telephone | 760-365-2800
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Fax | 760-365-1406
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Provider Business Mailing Address
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Address Line | PO BOX 1220
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City | JOSHUA TREE
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State | CA
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Zip | 92252-0810
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Country | US
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Telephone | 760-365-2800
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Fax | 760-365-1406
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 20A6300
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 20A6300
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License Number State | CA
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