Northern California Medical Assoc Inc

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

NORTHERN CALIFORNIA MEDICAL ASSOC INC

Practice address

4625 Quigg Dr
Santa Rosa, CA 95409-5377

Phone

(707) 537-2111

Fax

(707) 537-2119

NPI assigned

Sep 18, 2018

Organization subpart

No

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

Authorized official

Name

Sally A Dewald

Title

Director of Business SVCS

Phone

(707) 525-6485

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1841774759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE 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": "4625 QUIGG DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095377",
            "telephone_number": "707-537-2111",
            "fax_number": "707-537-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA MEDICAL ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-18",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "DEWALD",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS SVCS",
        "authorized_official_telephone_number": "707-525-6485"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Minimally Invasive Cardiovascular Surgery Inc

• Plastic and Reconstructive Surgery Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.