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NORTHERN CALIFORNIA MEDICAL ASSOC INC NPI 1689671570


NPI Information

NPI: 1689671570
Provider Name: NORTHERN CALIFORNIA MEDICAL ASSOC INC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
721 RIVER DR
STE A
FORT BRAGG, CA
ZIP 95437
Phone: (707) 573-6166
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NORTHERN CALIFORNIA MEDICAL ASSOC INC is a cardiovascular disease internal medicine in Fort Bragg, CA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. NORTHERN CALIFORNIA MEDICAL ASSOC INC NPI is 1689671570. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

721 RIVER DR
STE A
FORT BRAGG, CA
ZIP 95437-402
Phone: (707) 573-6166
Fax: (707) 573-6165

The provider's authorized official is Ruth Ann Skidmore .
The authorized official title is Chief Executive Officer and has the following contact phone number (707) 573-6925.

The enumeration date for this NPI number is 7/7/2005 and was last updated on 2/9/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RI0011XInternal MedicineInterventional CardiologyNo
2207RC0000XInternal MedicineCardiovascular DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZ01804ZOTHERCALIFORNIABLUE SHIELD OF CALIFORNIA
2ZZZ21309ZMEDICARE PINCALIFORNIA
3GR000173AMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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