Organization
NORTHERN CALIFORNIA MEDICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER)
(707) 573-6933
Entity
Organization
Contact information
Practice address
555 S DORA ST STE B, UKIAH, CA 95482-5424
(707) 462-3996
(707) 462-3363
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 573-6150
(707) 573-6160
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
10/19/2016
Last updated
12/12/2016
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