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NPI Code Detail

MEDICARE: IRVING EDUARDO JACOBO GAXIOLA

MEDICARE: IRVING EDUARDO JACOBO GAXIOLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1831063114
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRVING EDUARDO JACOBO GAXIOLA
Provider Business Mailing Address
First Line : 74699 TECHNOLOGY DR APT 1206
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-5808
Country : US
Telephone Number : 760-993-7271
Fax Number :
Provider Business Practice Location Address
First Line : 74699 TECHNOLOGY DR APT 1206
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-5808
Country : US
Telephone Number : 760-993-7271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2025
Last Update Date : 10/01/2025

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Directions to “ IRVING EDUARDO JACOBO GAXIOLA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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