Healthcare Provider Details

I. General information

NPI: 1003441288
Provider Name (Legal Business Name): ERVIN XHUFKA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2020
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

V. Phone/Fax

Practice location:
  • Phone: 760-837-8542
  • Fax: 760-837-8543
Mailing address:
  • Phone: 760-837-8542
  • Fax: 760-837-8543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95014144
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: