Northern California Medical Assoc Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHERN CALIFORNIA MEDICAL ASSOC INC

Practice address

104 Lynch Creek Way
Ste 10
Petaluma, CA 94954-2355

Phone

(707) 782-9123

Fax

(707) 782-9622

NPI assigned

Nov 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ruth A Skidmore

Title

Chief Executive Officer

Phone

(707) 573-6925

Specialties & licenses 2

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1245411529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE",
            "address_2": "STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-525-6485",
            "fax_number": "707-573-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LYNCH CREEK WAY",
            "address_2": "STE 10",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542355",
            "telephone_number": "707-782-9123",
            "fax_number": "707-782-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA MEDICAL ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "SKIDMORE",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-573-6925",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ51563Y",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245411529",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nosti and Gill Dental Corporatiom (Petaluma Modern Dentistry Dental Group)
• Carolina Espinosa Noya, RN,NP

• Family Medicine Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.