=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720997992
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VITEVA MEDICAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/03/2026
-----------------------------------------------------
Last Update Date | 09/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 625 E HERNDON AVE, SUITE 200
-----------------------------------------------------
City | CLOVIS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-512-3338
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1776 N RENN AVE
-----------------------------------------------------
City | CLOVIS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93619-8148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-512-3338
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | SAMIA GHAFFAR
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 559-246-5040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------