NUEVA ESPERANZA HEALTHCARE MEDICAL CLINIC INC.
NPI 1083767875
Family Medicine in Los Angeles, CA

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

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

Active since January 18, 2007CLIA 05D1033026 · Waiver

1704 W MANCHESTER AVE, SUITE 109, LOS ANGELES, CA 90047(323) 778-8485 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 29, 2020, Dec 7, 2017 (2 updates tracked since 2017).

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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 1083767875) is a healthcare organization registered as a family medicine in Los Angeles, California and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through November 2, 2026 and lists Amani Eldessouky, President, as its authorized official.

NPPES Registry Identity

NPI1083767875

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameNUEVA ESPERANZA HEALTHCARE MEDICAL CLINIC INC.

Location Address1704 W MANCHESTER AVE, SUITE 109Los Angeles, CA 90047-3034

Mailing Address1704 W Manchester Ave Ste 109Los Angeles, CA 90047-3056 · (323) 778-8485

Phone(323) 778-8485

Organization SubpartNo

Authorized OfficialAmani EldessoukyPresident · (323) 778-8485

Enumeration DateJanuary 18, 2007

Last NPPES UpdateOctober 29, 20202 updates tracked since enumeration

NPPES CertifiedOctober 29, 2020

✔ NPI 1083767875 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 · A56426

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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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nueva Esperanza Healthcare Medical Clinic Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Nueva Esperanza Healthcare Medical Clinic Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Amani Eldessouky, M.D.

Obstetrics/Gynecology

NPI 1528074044

1704 W MANCHESTER AVE SUITE 109
Los Angeles, CA 90047

(323) 778-8485

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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 1083767875. It was assigned to this organization in the NPPES registry on January 18, 2007.

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.

Is Nueva Esperanza Healthcare Medical Clinic Inc. enrolled in Medicare?

Yes. Nueva Esperanza Healthcare Medical Clinic Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Nueva Esperanza Healthcare Medical Clinic Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Obstetrics/Gynecology) reassigns their Medicare billing to Nueva Esperanza Healthcare Medical Clinic Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.