| Northern California Medical Assoc Inc | |
|
500 Doyle Park Dr Ste G03 Santa Rosa CA 95405-4559 | |
| (707) 544-3411 | |
| (707) 544-0834 |
| Full Name | Northern California Medical Assoc Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 500 Doyle Park Dr, Santa Rosa, California |
| Authorized Official Name and Position | Ruth Ann Skidmore (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7075736925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern California Medical Assoc Inc 3536 Mendocino Ave Ste 200 Santa Rosa CA 95403-3634 Ph: (707) 525-6485 | Northern California Medical Assoc Inc 500 Doyle Park Dr Ste G03 Santa Rosa CA 95405-4559 Ph: (707) 544-3411 |
| NPI Number | 1326243478 |
|---|---|
| Provider Enumeration Date | 06/19/2007 |
| Last Update Date | 12/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326243478 | NPI | - | NPPES |
| ZZZ50758Z | Other | BLUE SHIELD OF CALIFORNIA | |
| GR0001738 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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