Healthcare Provider Details

I. General information

NPI: 1619344272
Provider Name (Legal Business Name): XOLANI MDLULI MD INC A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2015
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N INDIAN CANYON DR SUITE E218
PALM SPRINGS CA
92262-4800
US

IV. Provider business mailing address

PO BOX 2644
PALM SPRINGS CA
92263-2644
US

V. Phone/Fax

Practice location:
  • Phone: 917-539-8672
  • Fax:
Mailing address:
  • Phone: 917-539-8672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA99214
License Number StateCA

VIII. Authorized Official

Name: XOLANI P MDLULI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 917-539-8672