# NORTHERN CALIFORNIA MEDICAL ASSOC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023205713
- **Authorized official:** MS. RUTH A. SKIDMORE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (707) 573-6925

## Contact information

- **Practice address:** 1111 SONOMA AVE, STE 202, SANTA ROSA, CA 95405-4813
- **Practice address phone:** (707) 546-7400
- **Practice address fax:** (707) 546-7474
- **Mailing address:** 3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
- **Mailing address phone:** (707) 525-6485
- **Mailing address fax:** (707) 573-6918

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2007
- **Last updated:** 10/27/2007