# NORTHERN CALIFORNIA MEDICAL ASSOC INC

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

## Provider details

- **NPI number:** 1124467006
- **Authorized official:** MS. RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (707) 573-6125

## Contact information

- **Practice address:** 1383 N MCDOWELL BLVD, STE 100, PETALUMA, CA 94954-1190
- **Practice address phone:** (707) 763-6400
- **Practice address fax:** (707) 763-6266
- **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 |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/24/2013
- **Last updated:** 05/05/2015