Healthcare Provider Details

I. General information

NPI: 1134838352
Provider Name (Legal Business Name): PAIR TEAM MEDICAL GROUP OF CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 3RD ST STE 293
SAN FRANCISCO CA
94103-3103
US

IV. Provider business mailing address

2261 MARKET ST STE 10011
SAN FRANCISCO CA
94114-1612
US

V. Phone/Fax

Practice location:
  • Phone: 707-207-6571
  • Fax:
Mailing address:
  • Phone: 707-207-6571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NATHAN FAVINI
Title or Position: PRINCIPAL
Credential:
Phone: 707-207-6571