Active NPI
Northern California Medical Assoc Inc
- Ophthalmology Physician
- Rohnert Park, CA
National Provider Identifier
1467720888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- NORTHERN CALIFORNIA MEDICAL ASSOC INC
- Practice address
- 1370 Medical Center Dr
Ste a
Rohnert Park, CA 94928-2934 - Phone
- (707) 585-6110
- Fax
- (707) 585-6145
- NPI assigned
- Dec 13, 2011
- Organization subpart
- No
NPPES NPI Registry
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | CA | Primary |
Addresses
Primary practice location
1370 Medical Center Dr
Ste a
Rohnert Park, CA 94928-2934
Mailing address
3536 Mendocino Ave
Ste 200
Santa Rosa, CA 95403-3634
Phone (707) 525-6485
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ69577Y | Other | CA | BLUE SHIELD |
| CN8040 | Other | CA | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323734400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1332374400000",
"number": "1467720888",
"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": "1370 MEDICAL CENTER DR",
"address_2": "STE A",
"city": "ROHNERT PARK",
"state": "CA",
"postal_code": "949282934",
"telephone_number": "707-585-6110",
"fax_number": "707-585-6145"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN CALIFORNIA MEDICAL ASSOC INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-13",
"last_updated": "2012-03-22",
"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": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ69577Y",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CN8040",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rohnert Park, CA
- Christopher James Nicolaou
- Mikayla Marie Nonog
- North Bay Eye Associates a Medical Corporation
- North Bay Eye Care Partnership, Inc
- Northbay Senior Solutions, Inc.
- Nancy Ann O'Brien, CNM
- James Theodore Ober, PHARMD
- Occupational Health Centers of California, a Medical Corporation
- Jody Okafor, PHARMD
- Natalie Olinik Lim
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.