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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
MS. RUTH A. SKIDMORE (CHIEF EXECUTIVE OFFICER)
(707) 573-6925
Entity
Organization
Contact information
Practice address
95 MONTGOMERY DR, STE 120, SANTA ROSA, CA 95404-6617
(707) 578-7530
(707) 578-7533
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 578-7530
(707) 578-7533
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Enumeration date
07/28/2011
Last updated
02/09/2012
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