Northern California Medical Assoc INC
Internal Medicine in Mendocino, CA. Organization (NPI-2).
NPI number1982603577
StatusActive
Last updated in NPPESFeb 9, 2012
Details
- NPI
- 1982603577
- Entity type
- Organization (NPI-2)
- Legal business name
- Northern California Medical Assoc INC
- Organization subpart
- No
- Enumeration date
- Jul 18, 2005
- Last updated
- Feb 9, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207RC0000X | Internal Medicine, Cardiovascular Disease | – | – | |
| 207RI0011X | Internal Medicine, Interventional Cardiology | – | – |
Practice location
45081 Little Lake StMendocino, CA 95460
Phone 707-573-6166 · Fax 707-573-6165
Mailing address
3536 Mendocino AveSte 200
Santa Rosa, CA 95403-3634
Phone 707-525-6485 · Fax 707-573-6918
Authorized official
Ruth Ann Skidmore
Chief Executive Officer
7075736925
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