# NORTHERN CALIFORNIA MEDICAL ASSOC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northern California Medical Associates, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588164909
- **Authorized official:** SALLY A DEWALD (DIRECTOR OF BUSINESS SERVICES)
- **Authorized official phone:** (707) 525-6485

## Contact information

- **Practice address:** 990 SONOMA AVE STE 18, SANTA ROSA, CA 95404
- **Practice address phone:** (707) 578-1222
- **Practice address fax:** (707) 578-8348
- **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 |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | — | NULL | — |
| 207RR0500X | Rheumatology Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | CA | Yes |

## Other

- **Enumeration date:** 02/13/2018
- **Last updated:** 08/07/2018