NORTHERN CALIFORNIA MEDICAL ASSOC INC (NPI# 1376540518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376540518 |
| Entity Type | Organization |
| Organization Name | NORTHERN CALIFORNIA MEDICAL ASSOC INC |
| Practice Address |
3536 Mendocino Ave Ste 200 Santa Rosa CA 95403-3634 |
| Practice Telephone | 7075736166 |
| Practice Fax Number | 7075736165 |
| Mailing Telephone | 7075256485 |
| Mailing Fax Number | 7075736918 |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2013-11-15 |
| Authorized Official Name | MS. RUTH ANN SKIDMORE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7075736925 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0001730 | 05 | |
| CA | BLUE SHIELD OF CALIFORNIA | ZZZ84894Z | 01 |
| 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 |
| 1225330459 | Northern California Medical Assoc Inc | Internal Medicine | 153 W Spruce St, Fort Bragg, CA 95437-3024 | 2010-11-19 |
| 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 |
| Street Address |
3536 MENDOCINO AVE STE 200 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95403-3634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164425914 | Patrick J Caskey | Ophthalmology | 3536 Mendocino Ave, Ste 380, Santa Rosa, CA 95403-3612 | 2005-05-24 |
| 1134517139 | Emine C. Loxley Dmd, PC | Clinic/Center | 3536 Mendocino Ave, Suite 330, Santa Rosa, CA 95403-3634 | 2014-12-30 |
| 1295152379 | Matthew Armstrong Powers | Student in an Organized Health Care Education/Training Program | 3536 Mendocino Ave, Ste 380, Santa Rosa, CA 95403-3612 | 2014-03-26 |
| 1083954515 | Deborah Ann Magee | Nurse Practitioner | 3536 Mendocino Ave, Suite 200, Santa Rosa, CA 95403-3634 | 2013-02-20 |
| 1407145477 | Nayabei Barretto | Nurse Practitioner | 3536 Mendocino Ave, Ste 200, Santa Rosa, CA 95403-3634 | 2011-03-30 |
| 1811128275 | Kimberly Brayton Brayton | Internal Medicine | 3536 Mendocino Ave, Ste 200, Santa Rosa, CA 95403-3634 | 2009-08-03 |
| 1144455825 | Vishal Ghanshyam Patel | Internal Medicine | 3536 Mendocino Ave, Ste 200, Santa Rosa, CA 95403-3634 | 2009-05-25 |
| 1881844397 | Deborah Wolff-baker | Nurse Practitioner | 3536 Mendocino Ave, Ste 300, Santa Rosa, CA 95403-3634 | 2008-09-22 |
| 1356540272 | Jaime Jeremy Molden | Internal Medicine | 3536 Mendocino Ave, Ste 200, Santa Rosa, CA 95403-3634 | 2007-07-11 |
| 1972704542 | Sutter Medical Foundation | Surgery | 3536 Mendocino Ave, Suite 300, Santa Rosa, CA 95403-3634 | 2007-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912549841 | Abundance Acupuncture Healing Clinic | Acupuncturist | 3410 Mendocino Avenue, Santa Rosa, CA 95403 | 2019-10-11 |
| 1982161337 | Crystal J Ward | Registered Nurse | 2350 Mendocino Ave, Ste A4, Santa Rosa, CA 95403 | 2019-02-21 |
| 1033674379 | George Edward Griese | Respiratory Therapist, Registered | 501 Bicentennial Way, Santa Rosa, CA 95403 | 2019-01-31 |
| 1508320672 | East-west Natural Medicine Inc. | Acupuncturist | 2200 Range Ave #207, Santa Rosa, CA 95403 | 2019-01-23 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1326519182 | Jkb Solutions Inc. | In Home Supportive Care | 3554 Round Barn Boulevard, Suite 311, Santa Rosa, CA 95403 | 2018-12-05 |
| 1487121265 | Catholic Charities of The Diocese of Santa Rosa | Clinic/Center | 987 Airway Ct, Santa Rosa, CA 95403 | 2018-10-30 |
| 1447746524 | Lisa Jean Quang | Optometrist | 3925 Old Redwood, Medical Office Building 4, Suite 141, Santa Rosa, CA 95403 | 2018-07-02 |
| 1598253353 | Jennifer Renee Lummus | Community Health Worker | 3614 Condo Court, Santa Rosa, CA 95403 | 2018-04-27 |
| 1871042366 | Sadie Thuet | Marriage & Family Therapist | 3434 A Mendocino Ave, Santa Rosa, CA 95403 | 2016-09-26 |
| Find all providers in zip 95403 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811074586 | Sanjay Chamanlal Dhar | Internal Medicine | 4740 Hoen Ave, Santa Rosa, CA 95405-7824 | 2006-11-01 |
| 1770527269 | Jose Veloso Ballesteros | Internal Medicine | 990 Sonoma Ave Ste 2, Santa Rosa, CA 95404-4813 | 2006-06-15 |
| 1205889839 | Norman Panting | Internal Medicine | 3949 Wallace Rd, Santa Rosa, CA 95404-1418 | 2006-05-17 |
| 1053305714 | Ashwani K Bedi | Internal Medicine | 3536 Mendocino Ave Ste 200, Santa Rosa, CA 95403-3634 | 2005-09-08 |
| 1558360479 | Patrick Devlin | Internal Medicine | 1111 Sonoma Ave, Suite 302, Santa Rosa, CA 95405-4819 | 2005-07-21 |
| 1417955287 | Donald Gregory Hopkins | Internal Medicine | 34 Mark West Springs Rd Ste 310, Santa Rosa, CA 95403 | 2005-07-14 |
| 1144764523 | Santa Rosa Vein Associates, Inc | Internal Medicine | 990 Sonoma Ave, Suite 2, Santa Rosa, CA 95404-4813 | 2016-12-05 |
| 1528359296 | Ali Yassen | Internal Medicine | 3536 Mendocino Ave Ste 200, Santa Rosa, CA 95403 | 2011-04-28 |
| 1558599969 | Emily Lai Conway | Internal Medicine | 34 Mark West Springs Rd Fl 3, Santa Rosa, CA 95403 | 2009-06-24 |
| 1144455825 | Vishal Ghanshyam Patel | Internal Medicine | 3536 Mendocino Ave, Ste 200, Santa Rosa, CA 95403-3634 | 2009-05-25 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95403 |
Please comment or provide details below to improve the information on NORTHERN CALIFORNIA MEDICAL ASSOC INC.
| 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.