Healthcare Provider Details

I. General information

NPI: 1285520957
Provider Name (Legal Business Name): PICTION HEALTH MEDICAL GROUP OF CALIFORNIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 3RD ST FL 2
SAN FRANCISCO CA
94103-3103
US

IV. Provider business mailing address

55 COURT ST FL 2
BOSTON MA
02108-2111
US

V. Phone/Fax

Practice location:
  • Phone: 781-650-4492
  • Fax:
Mailing address:
  • Phone: 781-650-4492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NIRAJ PATEL
Title or Position: PRESIDENT
Credential: DO
Phone: 716-400-7356