# NORTHERN CALIFORNIA MEDICAL ASSOC INC

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

## Provider details

- **NPI number:** 1467720888
- **Authorized official:** MS. RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (707) 573-6925

## Contact information

- **Practice address:** 1370 MEDICAL CENTER DR, STE A, ROHNERT PARK, CA 94928-2934
- **Practice address phone:** (707) 585-6110
- **Practice address fax:** (707) 585-6145
- **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 | — | CA | Yes |

## Other

- **Enumeration date:** 12/13/2011
- **Last updated:** 03/22/2012