Organization
NORTHERN CALIFORNIA MEDICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY A DEWALD (BUSINESS SERVICES MANAGER)
(707) 525-6485
Entity
Organization
Contact information
Practice address
1701 4TH ST STE 100, SANTA ROSA, CA 95404-3661
(707) 569-3234
Mailing address
3536 MENDOCINO AVE STE 200, SANTA ROSA, CA 95403-3634
(707) 545-6485
(707) 573-6918
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
207RI0008X
Hepatology Physician
—
—
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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