NPIMap

Organization Active NPI

Northern California Medical Assoc

Doing business as Northern California Medical Associates, Inc.

  • Sleep Medicine (Internal Medicine) Physician
  • Eureka, CA
National Provider Identifier
1912408691
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
NORTHERN CALIFORNIA MEDICAL ASSOC
Doing business as
Northern California Medical Associates, Inc.
Practice address
2315 Dean St
Eureka, CA 95501-3208
Phone
(707) 525-3786
Fax
(707) 525-3791
NPI assigned
Feb 27, 2018
Last updated
Feb 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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 Services
Phone
(707) 525-6485

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU Primary

Addresses

Primary practice location

2315 Dean St
Eureka, CA 95501-3208

Mailing address

3536 Mendocino Ave Ste 200
Santa Rosa, CA 95403-3634
Phone (707) 525-6485

Other names 1

  • Northern California Medical Associates, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northern California Medical Assoc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1912408691",
    "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": "2315 DEAN ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013208",
            "telephone_number": "707-525-3786",
            "fax_number": "707-525-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA MEDICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "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 SERVICES",
        "authorized_official_telephone_number": "707-525-6485"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern California Medical Associates, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.