# NORTHERN CALIFORNIA MEDICAL ASSOC INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1568840759
- **Authorized official:** MS. RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (707) 573-6925

## Contact information

- **Practice address:** 720 4TH ST, SANTA ROSA, CA 95404-4421
- **Practice address phone:** (707) 575-3800
- **Practice address fax:** (707) 528-4967
- **Mailing address:** 3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
- **Mailing address phone:** (707) 525-6485
- **Mailing address fax:** (707) 528-4967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/08/2015
- **Last updated:** 05/08/2015