Healthcare Provider Details

I. General information

NPI: 1154013753
Provider Name (Legal Business Name): JOSEPH LUBA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOEY LUBA

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N INDIAN CANYON DR
PALM SPRINGS CA
92262-4872
US

IV. Provider business mailing address

1150 N INDIAN CANYON DR
PALM SPRINGS CA
92262-4872
US

V. Phone/Fax

Practice location:
  • Phone: 760-323-6511
  • Fax: 760-323-6383
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberPTL5484
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: