NORTHERN CALIFORNIA MEDICAL ASSOC INC (NPI# 1619390077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619390077 |
| Entity Type | Organization |
| Organization Name | NORTHERN CALIFORNIA MEDICAL ASSOC INC |
| Practice Address |
175 Park St Lakeport CA 95453-4803 |
| Mailing Address |
3536 Mendocino Ave Ste 200 Santa Rosa CA 95403-3634 |
| Practice Telephone | 7072639595 |
| Practice Fax Number | 7072635576 |
| Mailing Telephone | 7075256485 |
| Mailing Fax Number | 7075736918 |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2015-05-05 |
| Authorized Official Name | MS. RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7075736925 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| 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 |
175 PARK ST |
| City | LAKEPORT |
| State | CA |
| Zip Code | 95453-4803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134122880 | James M Hagan | Podiatrist | 175 Park St, Lakeport, CA 95453-4803 | 2005-05-24 |
| 1932613759 | Parkview Podiatry | Podiatrist | 175 Park St, Lakeport, CA 95453-4803 | 2017-12-01 |
| 1417292723 | North Bay Foot and Ankle Clinic Inc | Podiatrist | 175 Park St, Lakeport, CA 95453-4803 | 2012-11-28 |
| 1477588549 | Adelina B Stateva | Podiatrist | 175 Park St, Lakeport, CA 95453-4803 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427526847 | Easter Seals Bay Area | Early Intervention Provider Agency | 1950 Parallel Drive, Lakeport, CA 95453 | 2018-11-03 |
| 1285000810 | Lake County Tribal Health Consortium, Inc. | Clinic/Center | 14678 Lakeshore Boulevard, Clearlake, CA 95453 | 2015-08-18 |
| 1942558721 | Lorena A Watson | Nurse Practitioner | 5108 Hill Road East, Lakeport, CA 95453 | 2012-08-27 |
| 1992024657 | Jennifer Stolworthy Smith | Case Manager/Care Coordinator | 991 Parallel Dr. Ste. B, County of Lake, Mental Health, Lakeport, CA 95453 | 2010-05-20 |
| 1376720664 | June Arisa Masato | Marriage & Family Therapist | 1152 S. Main St, Lakeport, CA 95453 | 2008-01-29 |
| 1245417021 | Robert Ryan Taylor Sr. | Physical Therapist | 1285 S Main Street, Lakeport, CA 95453 | 2008-01-24 |
| 1760669618 | Joan Kammerer | Registered Nurse | 922 Bevins Court, Lakeport, CA 95453 | 2008-01-23 |
| 1881878353 | Mary Theresa Mcmillan | Marriage & Family Therapist | 75 Fourth Street, Lakeport, CA 95453 | 2007-12-19 |
| 1922288984 | Robert William Krause | Family Medicine | 755 Eleventh St, Lakeport, CA 95453 | 2007-11-07 |
| 1568683092 | Dan Sleeth | Marriage & Family Therapist | 991 Parallel Dr., Lakeport, CA 95453 | 2007-05-01 |
| Find all providers in zip 95453 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134122880 | James M Hagan | Podiatrist | 175 Park St, Lakeport, CA 95453-4803 | 2005-05-24 |
| 1962405613 | Matthew Mcquaid | Podiatrist | 5150 Hill Rd E, Ste A, Lakeport, CA 95453-5100 | 2005-05-24 |
| 1932613759 | Parkview Podiatry | Podiatrist | 175 Park St, Lakeport, CA 95453-4803 | 2017-12-01 |
| 1477588549 | Adelina B Stateva | Podiatrist | 175 Park St, Lakeport, CA 95453-4803 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884610 | South Bay Foot & Ankle Specialists, Inc. | Podiatrist | 5565 Grossmont Center Dr Ste 510, La Mesa, CA 91942-3024 | 2020-09-07 |
| 1811512866 | Ankle & Foot Care Center Inc | Podiatrist | 15141 Whittier Blvd Ste 330, Whittier, CA 90603-2168 | 2020-06-15 |
| 1912528928 | Clement Podiatry PC | Podiatrist | 505 Sansome St Ste 850, San Francisco, CA 94111-3114 | 2020-04-30 |
| 1942834775 | Felix Sigal Dpm A Professional Corporation | Podiatrist | 201 S Alvarado St Ste 819, Los Angeles, CA 90057-2391 | 2020-03-02 |
| 1033758339 | Yosemite Bone and Joint Inc | Podiatrist | 1199 Delbon Ave Ste 1, Turlock, CA 95382-2006 | 2020-01-03 |
| 1194361634 | K David Flora Dpm Inc | Podiatrist | 1086 N Cherry St, Tulare, CA 93274-2251 | 2019-11-19 |
| 1902457963 | Silverlake Virgil Surgery Center | Podiatrist | 3367 W 1st St Ste 204, Los Angeles, CA 90004-6080 | 2019-09-21 |
| 1134778178 | Mohamad Belal Sharif | Podiatrist | Va Loma Linda 11201 Benton St, Loma Linda, CA 92357-0001 | 2019-09-11 |
| 1972159366 | Bay Area Surgical Specialists Inc A Medical Corporation | Podiatrist | 6061 N 1st St Ste 103, Fresno, CA 93710-5470 | 2019-08-13 |
| 1790331189 | Bay Area Surgical Specialists Inc A Medical Corporation | Podiatrist | 774 N Prospect St Ste B, Porterville, CA 93257-1941 | 2019-08-13 |
| Find all providers with the same taxonomy | ||||
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.