NORTHERN CALIFORNIA MEDICAL ASSOC INC NPI 1376540518

NPI Information

NPI: 1376540518
Provider Name: NORTHERN CALIFORNIA MEDICAL ASSOC INC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
3536 MENDOCINO AVE
STE 200
SANTA ROSA, CA
ZIP 95403
Phone: (707) 573-6166
Get Directions

NORTHERN CALIFORNIA MEDICAL ASSOC INC is a cardiovascular disease internal medicine in Santa Rosa, 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 1376540518. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3536 MENDOCINO AVE
STE 200
SANTA ROSA, CA
ZIP 95403-634
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 7/1/2005 and was last updated on 11/15/2013.

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	207UN0901X	Nuclear Medicine	Nuclear Cardiology	No
4	208100000X	Physical Medicine & Rehabilitation		No
5	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)		No
6	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	No
7	207R00000X	Internal Medicine		No
8	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	GR0001730	MEDICAID	CALIFORNIA
2	ZZZ84894Z	OTHER	CALIFORNIA	BLUE SHIELD OF CALIFORNIA
3	ZZZ84894Z	MEDICARE PIN	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: 4/28/2024

NPI Synchronization or Removal

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