Organization
INNOVATIVE MEDICAL GROUP NJ, LLC
Active
Other names
Forward
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN FAVINI MD (MANAGER)
(415) 349-0850
Entity
Organization
Contact information
Practice address
660 4TH ST # 202, SAN FRANCISCO, CA 94107-1618
(415) 349-0850
Mailing address
660 4TH ST # 202, SAN FRANCISCO, CA 94107-1618
(415) 349-0850
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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