# NUEVA VIDA MEDICAL INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316017809
- **Authorized official:** DR. ISSAM KHAFAJA M.D. (PRESIDENT)
- **Authorized official phone:** (213) 484-6444

## Contact information

- **Practice address:** 1725 BEVERLY BLVD, STE 103, LOS ANGELES, CA 90026-5401
- **Practice address phone:** (213) 484-6444
- **Practice address fax:** (213) 484-6555
- **Mailing address:** 1725 BEVERLY BLVD, STE 103, LOS ANGELES, CA 90026-5401
- **Mailing address phone:** (213) 484-6444
- **Mailing address fax:** (213) 484-6555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A54280 | CA | — |
| 208D00000X | General Practice Physician | A54280 | CA | Yes |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 09/11/2025