| Nueva Vida Medical Inc. | |
|
1725 Beverly Blvd Ste 103 Los Angeles CA 90026-5401 | |
| (213) 484-6444 | |
| (213) 484-6555 |
| Full Name | Nueva Vida Medical Inc. |
|---|---|
| Speciality | General Practice |
| Location | 1725 Beverly Blvd, Los Angeles, California |
| Authorized Official Name and Position | Issam Khafaja (PRESIDENT) |
| Authorized Official Contact | 2134846444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nueva Vida Medical Inc. 1725 Beverly Blvd Ste 103 Los Angeles CA 90026-5401 Ph: (213) 484-6444 | Nueva Vida Medical Inc. 1725 Beverly Blvd Ste 103 Los Angeles CA 90026-5401 Ph: (213) 484-6444 |
| NPI Number | 1316017809 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316017809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A54280 (California) | Primary |
| 208D00000X | General Practice | A54280 (California) | Primary |
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