Healthcare Provider Details

I. General information

NPI: 1871334649
Provider Name (Legal Business Name): PAIRTU HEALTH MEDICAL GROUP OF CALIFORNIA P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 MONTGOMERY ST FL 1011
SAN FRANCISCO CA
94111-6529
US

IV. Provider business mailing address

PO BOX 96683
PHOENIX AZ
85072-6683
US

V. Phone/Fax

Practice location:
  • Phone: 323-310-4183
  • Fax: 833-427-1156
Mailing address:
  • Phone: 323-310-4183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ARIAN RAZZAGHI
Title or Position: CEO
Credential:
Phone: 310-415-5817