# NORTHERN CALIFORNIA MEDICAL ASSOC INC

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

## Provider details

- **NPI number:** 1528481983
- **Authorized official:** MS. RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (707) 573-6925

## Contact information

- **Practice address:** 500 DOYLE PARK DR, STE 103, SANTA ROSA, CA 95405-4559
- **Practice address phone:** (707) 579-1102
- **Practice address fax:** (707) 579-1386
- **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 |
| --- | --- | --- | --- | --- |
| 207VX0000X | Obstetrics Physician | — | NULL | Yes |
| 207VX0000X | Obstetrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/21/2014
- **Last updated:** 05/05/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1528481983 | — | CA |