NORTHERN CALIFORNIA MEDICAL ASSOC INC


Address: 1701 4th St, Ste 120, Santa Rosa, CA 95404-3661
Phone: 7075237025

NORTHERN CALIFORNIA MEDICAL ASSOC INC (NPI# 1396040226) 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) 1396040226
Entity Type Organization
Organization Name NORTHERN CALIFORNIA MEDICAL ASSOC INC
Practice Address 1701 4th St
Ste 120
Santa Rosa
CA 95404-3661
Mailing Address 3536 Mendocino Ave
Ste 200
Santa Rosa
CA 95403-3634
Practice Telephone 7075237025
Practice Fax Number 7075233024
Mailing Telephone 7075756049
Mailing Fax Number 7075233024
Enumeration Date 2011-01-25
Last Update Date 2018-11-05
Authorized Official Name MS. RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 7075256925
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207YS0123X Otolaryngology
Specialization: Facial Plastic Surgery
Allopathic & Osteopathic Physicians
N 2086S0122X Surgery
Specialization: Plastic and Reconstructive Surgery
Allopathic & Osteopathic Physicians
N 231H00000X Audiologist Speech, Language and Hearing Service Providers
Y 207Y00000X Otolaryngology Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA 1396040226 05
CA BLUE SHIELD ZZZ38629Z 01
CA RAILROAD MEDICARE CN8040 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
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

Office Location

Street Address 1701 4TH ST
STE 120
City SANTA ROSA
State CA
Zip Code 95404-3661

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083690259 Paul Doey Mcadams Urology 1701 4th St, Suite 200, Santa Rosa, CA 95404-3658 2005-12-20
1184245870 Dona Pierantoni Brumbley Radiology 1701 4th St, Santa Rosa, CA 95404-3658 2020-05-04
1114274388 Jayme Fellores Audiologist 1701 4th St, Suite 120, Santa Rosa, CA 95404-3658 2012-08-07
1306078050 Adam Geoffrey Kaplan Urology 1701 4th St, Suite 200, Santa Rosa, CA 95404-3658 2009-08-13
1023246089 Anton Kushnaryov Otolaryngology 1701 4th St, Ste 120, Santa Rosa, CA 95404-3661 2009-06-30
1275772907 John B Jarvis Audiologist 1701 4th St, Ste 120, Santa Rosa, CA 95404-3661 2009-02-19
1558515882 Laurence H. Smith, M.d., Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) 1701 4th St, Suite 200, Santa Rosa, CA 95404-3601 2008-11-13
1871754887 Kristin Anne Kline Audiologist 1701 4th St, Suite 120, Santa Rosa, CA 95404-3658 2008-06-23
1447422043 Marshall V. Marchbanks, M.d., Medical Corp Thoracic Surgery (Cardiothoracic Vascular Surgery) 1701 4th St, Suite 200, Santa Rosa, CA 95404-3601 2008-03-24
1457534174 Northern California Medical Assoc Inc Surgery 1701 4th St, Ste 200, Santa Rosa, CA 95404-3601 2007-12-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205442217 David Lee Dutton Counselor 201 S. E Street, Santa Rosa, CA 95404 2020-09-16
1114492162 Jesse Earl Rathbun Jr. Ophthalmology 1920 Grace Dr., Santa Rosa, CA 95404 2018-10-05
1568958437 Bianca Avina Marriage & Family Therapist 95 Montgomery Dr. #112, Santa Rosa, CA 95404 2018-07-03
1366940504 New Leaf Counseling and Psychotherapy Marriage & Family Therapist 1030 2n Street, Suite B, Santa Rosa, CA 95404 2018-01-23
1659884864 Jessica Vargas Lopez Counselor 3333 Chanate Road, Santa Rosa, CA 95404 2017-11-09
1982135992 Gaea Keridwyn Coon Marriage & Family Therapist 884 Third Street, Suite D, Santa Rosa, CA 95404 2017-03-22
1376084699 Empire Traditional Chinese Medicine Acupuncturist 1030 Second St, Santa Rosa, CA 95404 2017-03-20
1356888705 Webster Surgery Center, Lp Clinic/Center 730 Bennett Valley Road, Santa Rosa, CA 95404 2017-01-24
1205295979 Sandra Lee Krikorian Social Worker 101 E Street, Suite 312, Santa Rosa, CA 95404 2016-02-23
1396134615 The Center for Body Oriented Psychotherapy & Wellness Psychologist 1626 Fourth Street, Santa Rosa, CA 95404 2015-01-12
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477528859 Alexander J Lozano Otolaryngology 2025 Bent Tree Pl, Santa Rosa, CA 95404-1570 2006-02-21
1063486546 Kim Elaine Schmitt Otolaryngology 1701 4th St Ste 120, Santa Rosa, CA 95404 2006-02-14
1205213170 Annick Aubin-pouliot Otolaryngology 1701 4th St Ste 120, Santa Rosa, CA 95404-3661 2015-04-30
1982947404 Elizabeth Debra Cedars Otolaryngology 1701 4th St Ste 120, Santa Rosa, CA 95404 2013-04-03
1760717441 North Coast Faculty Medical Group Inc. Otolaryngology 1144 Sonoma Ave, 101, Santa Rosa, CA 95405-4812 2009-10-13
1023246089 Anton Kushnaryov Otolaryngology 1701 4th St, Ste 120, Santa Rosa, CA 95404-3661 2009-06-30
1225203862 Richard Turley Otolaryngology 401 Bicentennial Way, Santa Rosa, CA 95403-2149 2008-04-24
1699963231 Stephanie Su Huang Otolaryngology 1701 4th St, Ste 120, Santa Rosa, CA 95404-3661 2007-10-09
1346315181 Dr Jeff Broffman A Medical Corp Otolaryngology 1144 Sonoma Ave, #101, Santa Rosa, CA 95405 2006-11-21
1881773927 Charles Daniel Sooy Otolaryngology 401 Bicentennial Way, Santa Rosa, CA 95403-2149 2006-11-02
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City SANTA ROSA
Zip Code 95404

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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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