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NUEVA ESPERANZA HEALTHCARE MEDICAL CLINIC INC.
NPI 1063781565
Family Medicine in Los Angeles, CA

Active since December 29, 2011CLIA 05D1033026 · Waiver
1704 W MANCHESTER AVE, SUITE 109, LOS ANGELES, CA 90047(323) 778-8485(323) 778-4452 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nueva Esperanza Healthcare Medical Clinic Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NUEVA ESPERANZA HEALTHCARE MEDICAL CLINIC INC. (NPI 1063781565) is a healthcare organization registered as a family medicine in Los Angeles, California and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through November 2, 2026 and lists Amani A Eldessouky, President, as its authorized official.

NPPES Registry Identity

NPI1063781565
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNUEVA ESPERANZA HEALTHCARE MEDICAL CLINIC INC.
Location Address1704 W MANCHESTER AVE, SUITE 109Los Angeles, CA 90047-3063
Mailing Address1704 W Manchester Ave, Suite 109Los Angeles, CA 90047-3063 · (323) 778-8485 · Fax (323) 778-4452
Phone(323) 778-8485
Fax(323) 778-4452
Organization SubpartNo
Authorized OfficialAmani A EldessoukyPresident · (323) 778-8485
Enumeration DateDecember 29, 2011
Last NPPES UpdateOctober 29, 2020
NPPES CertifiedOctober 29, 2020
✔ NPI 1063781565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A106748
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1704 W MANCHESTER AVE, Los Angeles, CA 90047
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Other Identifiers 1

MedicaidA106748CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1033026

Nueva Esperanza Healthcare Medical Clinic Inc · Los Angeles, CA
Active · expires Nov 2, 2026
CLIA Number05D1033026
Laboratory TypePhysician Office
Certificate Effective DateNovember 3, 2024
Certificate Expiration DateNovember 2, 2026
Laboratory DirectorAmani A. Eldesouky MD
Laboratory Phone(323) 778-8485
Laboratory LocationNueva Esperanza Healthcare Medical Clinic Inc1704 W Manchester Ave Suite 109, Los Angeles, CA 90047
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PACIFIC COAST MEDICAL SUPPLY
Durable Medical Equipment & Medical Supplies
1704 W MANCHESTER AVE, SUITE 105
LOS ANGELES, CA 90047
Los Angeles County (562) 706-4552
LOVING TOUCH HOSPICE CARE, INC.
Hospice Care, Community Based
1704 W MANCHESTER AVE, SUITE 101-D
LOS ANGELES, CA 90047
Los Angeles County (323) 789-6728
CORDELIA O EZE BS
Counselor (Addiction (Substance Use Disorder))
1704 W MANCHESTER AVE, SUITE 105
LOS ANGELES, CA 90047
Los Angeles County (323) 759-6224
MORNINGSIDE PRIMARY CARE MEDICAL CTR, INC
General Practice
1704 W MANCHESTER AVE, SUITE 101
LOS ANGELES, CA 90047
Los Angeles County (323) 778-6215
NUEVA ESPERANZA HEALTHCARE MEDICAL CLINIC INC.
Family Medicine
1704 W MANCHESTER AVE, SUITE 109
LOS ANGELES, CA 90047
Los Angeles County (323) 778-8485
HENRIETTA WILLIAMS CAADAC
Counselor (Addiction (Substance Use Disorder))
1704 W MANCHESTER AVE, # 205
LOS ANGELES, CA 90047
Los Angeles County (323) 751-0608
MR. POTENCIANO REYNOSO PAREDES M.D.
Pediatrics
1704 W MANCHESTER AVE, SUITE 101
LOS ANGELES, CA 90047
Los Angeles County (323) 778-6215
JAMES O. EZE
Durable Medical Equipment & Medical Supplies
1704 W MANCHESTER AVE, SUITE 204C
LOS ANGELES, CA 90047
Los Angeles County (323) 750-1817

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nueva Esperanza Healthcare Medical Clinic Inc.'s NPI number?

The NPI number for Nueva Esperanza Healthcare Medical Clinic Inc. is 1063781565. It was assigned to this organization in the NPPES registry on December 29, 2011.

Where is Nueva Esperanza Healthcare Medical Clinic Inc. located?

Nueva Esperanza Healthcare Medical Clinic Inc. is located at 1704 W Manchester Ave Suite 109, Los Angeles, CA 90047. The listed phone number is (323) 778-8485.

What is Nueva Esperanza Healthcare Medical Clinic Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Nueva Esperanza Healthcare Medical Clinic Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1033026) is associated with this NPI, valid through November 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Nueva Esperanza Healthcare Medical Clinic Inc. was last updated on October 29, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.