# NU LIFE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1891176350
- **Authorized official:** HESSAM EFTEKHARI DO (OWNER)
- **Authorized official phone:** (619) 957-4726

## Contact information

- **Practice address:** 31371 RANCHO VIEJO RD STE 104, SAN JUAN CAPISTRANO, CA 92675-1848
- **Practice address phone:** (949) 565-0444
- **Mailing address:** 31371 RANCHO VIEJO RD STE 104, SAN JUAN CAPISTRANO, CA 92675-1848
- **Mailing address phone:** (949) 565-0444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | 20A9311 | CA | — |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | 20A9311 | CA | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 20A9311 | CA | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | 20A9311 | CA | — |
| 208D00000X | General Practice Physician | 20A9311 | CA | Yes |
| 208VP0000X | Pain Medicine Physician | 20A9311 | CA | — |

## Other

- **Enumeration date:** 06/10/2015
- **Last updated:** 10/13/2015