Healthcare Provider Details

I. General information

NPI: 1952046450
Provider Name (Legal Business Name): RUBA ALCHAIKH HASSAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67780 E PALM CANYON DR
CATHEDRAL CITY CA
92234-5441
US

IV. Provider business mailing address

67780 E PALM CANYON DR
CATHEDRAL CITY CA
92234-5441
US

V. Phone/Fax

Practice location:
  • Phone: 760-837-8993
  • Fax: 760-837-8994
Mailing address:
  • Phone: 760-837-8993
  • Fax: 760-837-8994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA202250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: