# NORCAL SKIN DISEASE AND SURGERY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NorCal Dermatology Medical Surgical Cosmetic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881839520
- **Authorized official:** ALICIA BROPHY CMOM, CMA (PRACTICE MANAGER)
- **Authorized official phone:** (707) 527-9517

## Contact information

- **Practice address:** 196 WIKIUP DR, SANTA ROSA, CA 95403-7773
- **Practice address phone:** (707) 527-9517
- **Practice address fax:** (707) 527-9913
- **Mailing address:** 196 WIKIUP DR, SANTA ROSA, CA 95403-7773
- **Mailing address phone:** (707) 527-9517
- **Mailing address fax:** (707) 527-9913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A55665 | CA | Yes |

## Other

- **Enumeration date:** 12/10/2008
- **Last updated:** 11/22/2022