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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
2725 MENDOCINO AVE, SANTA ROSA, CA 95403-2805
(707) 545-4537
(707) 545-6726
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 525-6485
(707) 573-6918

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician

Other

Enumeration date
10/21/2016
Last updated
11/29/2016
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