Provider Demographics
NPI:1043418023
Name:MDLULI, XOLANI PERCY (MD)
Entity Type:Individual
Prefix:
First Name:XOLANI
Middle Name:PERCY
Last Name:MDLULI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2644
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-2644
Mailing Address - Country:US
Mailing Address - Phone:917-539-8672
Mailing Address - Fax:760-544-6166
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE E218
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:917-539-8672
Practice Address - Fax:760-544-6166
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99214207R00000X, 207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA168267Medicare PIN