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Organization
NORTHERN CALIFORNIA MEDICAL ASSOC INC
Active
Organization
NORTHERN CALIFORNIA MEDICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY A DEWALD (DIRECTOR OF BUSINESS SERVICES)
(707) 525-6485
Entity
Organization
Contact information
Practice address
1701 4TH ST STE 100, SANTA ROSA, CA 95404
(707) 578-1222
(707) 578-8348
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 525-6485
(707) 573-6918
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
06/30/2008
Last updated
09/04/2018
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