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
175 PARK ST, LAKEPORT, CA 95453-4803
(707) 263-9595
(707) 263-5576
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
213E00000X
Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
01/21/2014
Last updated
05/05/2015
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