Organization
NORTHERN CALIFORNIA MEDICAL ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY A DEWALD (DIRECTOR OF BUSINESS SERVICES)
(707) 525-6485
Entity
Organization
Contact information
Practice address
1701 4TH ST STE 100, SANTA ROSA, CA 95404-3661
(707) 573-6942
(707) 575-6038
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
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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