Organization
NUEVA VIDA MEDICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISSAM KHAFAJA M.D. (PRESIDENT)
(213) 484-6444
Entity
Organization
Contact information
Practice address
1725 BEVERLY BLVD, STE 103, LOS ANGELES, CA 90026-5401
(213) 484-6444
(213) 484-6555
Mailing address
1725 BEVERLY BLVD, STE 103, LOS ANGELES, CA 90026-5401
(213) 484-6444
(213) 484-6555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A54280
CA
208D00000X
General Practice Physician
Primary
A54280
CA
Other
Enumeration date
11/09/2006
Last updated
09/11/2025
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