# 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:** 1679851448
- **Authorized official:** MS. RUTH A. SKIDMORE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (707) 573-6925

## Contact information

- **Practice address:** 95 MONTGOMERY DR, STE 120, SANTA ROSA, CA 95404-6617
- **Practice address phone:** (707) 578-7530
- **Practice address fax:** (707) 578-7533
- **Mailing address:** 3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
- **Mailing address phone:** (707) 578-7530
- **Mailing address fax:** (707) 578-7533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2011
- **Last updated:** 02/09/2012