NORTHERN CALIFORNIA MEDICAL ASSOC INC NPI 1184845182

NPI Information

NPI: 1184845182
Provider Name: NORTHERN CALIFORNIA MEDICAL ASSOC INC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
652 PETALUMA AVE
STE E
SEBASTOPOL, CA
ZIP 95472
Phone: (707) 573-6166
Get Directions

NORTHERN CALIFORNIA MEDICAL ASSOC INC is a cardiovascular disease internal medicine in Sebastopol, 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 1184845182. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

652 PETALUMA AVE
STE E
SEBASTOPOL, CA
ZIP 95472-266
Phone: (707) 573-6166
Fax: (707) 573-6165

The provider's authorized official is Ruth A. 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 5/1/2007 and was last updated on 10/1/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207RC0001X	Internal Medicine	Clinical Cardiac Electrophysiology	No
2	207RI0011X	Internal Medicine	Interventional Cardiology	No
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)		No
4	207RC0000X	Internal Medicine	Cardiovascular Disease	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ZZZ36920Z	OTHER	CALIFORNIA	BLUE SHIELD OF CALIFORNIA
2	ZZZ37618Z	MEDICARE PIN	CALIFORNIA
3	GR000173J	MEDICAID	CALIFORNIA

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: 11/14/2023

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