Nueva Vida Medical Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A54280 Issued in CA

Legal business name

NUEVA VIDA MEDICAL INC.

Practice address

1725 Beverly Blvd
Ste 103
Los Angeles, CA 90026-5401

Phone

(213) 484-6444

Fax

(213) 484-6555

NPI assigned

Nov 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Issam Khafaja, M.D.NPI 1528062874

Title

President

Phone

(213) 484-6444

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Issam N Khafaja, M.D.

  • Internal Medicine Physician
  • Glendale, CA
  • NPI 1528062874
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1316017809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 BEVERLY BLVD",
            "address_2": "STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900265401",
            "telephone_number": "213-484-6444",
            "fax_number": "213-484-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 BEVERLY BLVD",
            "address_2": "STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900265401",
            "telephone_number": "213-484-6444",
            "fax_number": "213-484-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUEVA VIDA MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KHAFAJA",
        "authorized_official_first_name": "ISSAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-484-6444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A54280",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A54280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Los Angeles, CA
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.