NORTHERN CALIFORNIA MEDICAL ASSOC INC


Address: 153 W Spruce St, Fort Bragg, CA 95437-3024
Phone: 7074621516

NORTHERN CALIFORNIA MEDICAL ASSOC INC (NPI# 1225330459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225330459
Entity Type Organization
Organization Name NORTHERN CALIFORNIA MEDICAL ASSOC INC
Practice Address 153 W Spruce St
Fort Bragg
CA 95437-3024
Mailing Address 3536 Mendocino Ave
Ste 200
Santa Rosa
CA 95403-3634
Practice Telephone 7074621516
Practice Fax Number 7074621178
Mailing Telephone 7075756049
Mailing Fax Number 7075736918
Enumeration Date 2010-11-19
Last Update Date 2012-02-09
Authorized Official Name MS. RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 7075736925
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
Allopathic & Osteopathic Physicians
N 207RS0012X Internal Medicine
Specialization: Sleep Medicine
Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine Allopathic & Osteopathic Physicians
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA 1225330459 05
CA BLUE SHIELD ZZZ36793Z 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1922640820 Northern California Medical Assoc Inc Internal Medicine 830 2nd St Ste A, Santa Rosa, CA 95404-4620 2019-10-11
1235782921 Northern California Medical Assoc Inc Dermatology 4727 Hoen Ave Ste A, Santa Rosa, CA 95405-7898 2019-07-22
1427509959 Northern California Medical Assoc Inc Dermatology 555 S Dora St Ste B, Ukiah, CA 95482-5424 2016-10-19
1275945958 Northern California Medical Assoc Inc Dermatology 1165 South Dora St, Ste G2, Ukiah, CA 95482-6353 2014-05-29
1245492321 Northern California Medical Assoc Inc Podiatrist 1701 4th St Ste 100, Santa Rosa, CA 95404 2008-06-30
1548262926 Northern California Medical Assoc Inc Internal Medicine 558 3rd St W, Sonoma, CA 95476-6502 2005-08-15
1174525554 Northern California Medical Assoc Inc Internal Medicine 84 Madrone St, Willits, CA 95490-4249 2005-08-15
1760481204 Northern California Medical Assoc Inc Internal Medicine 4702 Hoen Ave, Santa Rosa, CA 95405-7824 2005-07-18
1073512661 Northern California Medical Assoc Inc Internal Medicine 717 Center St, Healdsburg, CA 95448-3604 2005-07-18
1649279233 Northern California Medical Assoc Inc Internal Medicine 46900 Ocean Dr, Gualala, CA 95445-8353 2005-07-18

Office Location

Street Address 153 W SPRUCE ST
City FORT BRAGG
State CA
Zip Code 95437-3024

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902357437 Mendocino Coast Hospitality Center Community/Behavioral Health 137 E. Oak Street, Fort Bragg, CA 95437 2016-10-19
1144604570 Erin Paul Community Health Worker 474 South Franklin Street, Fort Bragg, CA 95437 2015-07-15
1508125790 Joel Macgregor Green Marriage & Family Therapist 331- G Redwood Ave., Fort Bragg, CA 95437 2012-05-09
1013244102 Jenna Glasscock Counselor 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 2009-11-10
1770819641 Patrick Lenaghan Emergency Medicine 707 River Dr, Fort Bragg, CA 95437 2009-10-27
1043455827 M. Lee Baker Dentist 890 River Dr, Fort Bragg, CA 95437 2008-12-09
1528250495 Christine Anne Samas Social Worker 656a Harrison St., Fort Bragg, CA 95437 2007-08-15
1083822811 Katharine L. White Marriage & Family Therapist 137 E Oak Street, Fort Bragg, CA 95437 2007-05-17
1053525873 Marty Christine Johnson Marriage & Family Therapist 331 E. Redwood Ave, Fort Bragg, CA 95437 2007-05-10
1528114741 Kate Teresa Donohue Psychologist 19201 Noyo Acres Dr, Fort Bragg, CA 95437 2007-01-29
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1184221137 Newport Superior Medical & Infusion Inc Internal Medicine 1501 Superior Ave Ste 111, Newport Beach, CA 92663-3661 2020-10-02
1205472339 Christian Gronbeck IIi Internal Medicine 37 E Mission Ave, San Rafael, CA 94901-4208 2019-11-25
1497304497 Ralph Zitnik Internal Medicine 606 E Valerio St, Santa Barbara, CA 93103-1954 2019-09-11
1578118295 Adventist Health Physicians Network Internal Medicine 1231 W Vine St Ste 19, Lodi, CA 95240-5109 2019-08-08
1063079176 Kasra Sedarati M.d. Inc. Internal Medicine 325 N Maple Dr Unit 1863, Beverly Hills, CA 90213-4754 2019-05-23
1124586367 Coast Concierge Medicine Inc Internal Medicine 31852 Coast Hwy Ste 201, Laguna Beach, CA 92651-6765 2019-03-06
1801373352 Antelope Valley Lung & Sleep Institute, Inc Internal Medicine 1331 W Avenue J Ste 101, Lancaster, CA 93534-2942 2018-07-26
1659864338 Orange County Respiratory Physicians Corp Internal Medicine 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 2018-06-07
1841780301 San Joaquin Critical Care Medical Group, Inc. Internal Medicine 1801 E March Ln Ste C300, Stockton, CA 95210-6657 2018-05-10
1912408691 Northern California Medical Assoc Internal Medicine 2315 Dean St, Eureka, CA 95501-3208 2018-02-27
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Competitor

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City FORT BRAGG
Zip Code 95437

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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