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MORONGO BASIN OB/GYN NPI 1992705370


NPI Information

NPI: 1992705370
Provider Name: MORONGO BASIN OB/GYN

Former Legal Business Name: DR. ANDRE KASKO

Classification: Obstetrics & Gynecology - 207VC0200X
Entity Type: Organization

Specialization: Critical Care Medicine

CLIA Number: 05D1029261

Address:
57445 29 PALMS HWY
STE 301
YUCCA VALLEY, CA
ZIP 92284
Phone: (760) 365-2800
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MORONGO BASIN OB/GYN is a critical care medicine obstetrics gynecology in Yucca Valley, CA. The provider is an obstetrician/gynecologist, who specializes in critical care medicine diagnoses, treats and supports female patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. MORONGO BASIN OB/GYN NPI is 1992705370. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Dr. Andre Kasko.

The provider's business location address is:

57445 29 PALMS HWY
STE 301
YUCCA VALLEY, CA
ZIP 92284-947
Phone: (760) 365-2800
Fax: (760) 365-1406

The provider's authorized official is Andre M Kasko .
The authorized official title is Ceo and has the following contact phone number (760) 365-2800.

The CLIA number assigned to this NPI record is 05D1029261 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2005 and was last updated on 3/12/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VC0200XObstetrics & GynecologyCritical Care Medicine20A6300CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F41038MEDICARE UPIN
200AX63000MEDICAIDCALIFORNIA
3222321072MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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