Norcal Medical Supply, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORCAL MEDICAL SUPPLY, INC

Practice address

620 Petaluma Blvd N Ste a
Petaluma, CA 94952-2870

Phone

(707) 769-9606

Fax

(707) 776-4659

NPI assigned

Oct 26, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Sherian Lea Prince

Title

Shareholder

Phone

(707) 769-9606

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1669949707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4495",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949554495",
            "telephone_number": "707-769-9606",
            "fax_number": "707-776-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PETALUMA BLVD N STE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522870",
            "telephone_number": "707-769-9606",
            "fax_number": "707-776-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORCAL MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-26",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "SHERIAN",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "707-769-9606",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark John Nizibian, D.D.S.
• Alisha Louise Noel
• Blake Thomas Nogleberg
• Nudrat Raza Noorani
• Norcal Healthconnect LLC
• North Bay Dermatology & Skin Cancer Center P C
• North Bay Dermatology Assoc
• North Bay Dermatology Associates
• North Bay Electrology
• North Bay Endoscopy Center LLC

• Durable Medical Equipment & Medical Supplies in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.