Organization
NU LIFE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HESSAM EFTEKHARI DO (OWNER)
(619) 957-4726
Entity
Organization
Contact information
Practice address
31371 RANCHO VIEJO RD STE 104, SAN JUAN CAPISTRANO, CA 92675-1848
(949) 565-0444
Mailing address
31371 RANCHO VIEJO RD STE 104, SAN JUAN CAPISTRANO, CA 92675-1848
(949) 565-0444
Taxonomy
Speciality
Code
Description
License number
State
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
Primary
20A9311
CA
208VP0000X
Pain Medicine Physician
20A9311
CA
Other
Enumeration date
06/10/2015
Last updated
10/13/2015
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