NORTHERN CALIFORNIA MEDICAL ASSOC INC (NPI# 1003815606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003815606 |
| Entity Type | Organization |
| Organization Name | NORTHERN CALIFORNIA MEDICAL ASSOC INC |
| Practice Address |
719 Southpoint Blvd Ste B Petaluma CA 94954-1495 |
| Mailing Address |
3536 Mendocino Ave Ste 200 Santa Rosa CA 95403-3634 |
| Practice Telephone | 7077788421 |
| Practice Fax Number | 7077781702 |
| Mailing Telephone | 7075256485 |
| Mailing Fax Number | 7075736918 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2012-02-09 |
| Authorized Official Name | MS. RUTH ANN SKIDMORE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7075736925 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD OF CALIFORNIA | ZZZ37618Z | 01 |
| CA | GR0001735 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922640820 | Northern California Medical Assoc Inc | Internal Medicine | 830 2nd St Ste A, Santa Rosa, CA 95404-4620 | 2019-10-11 |
| 1235782921 | Northern California Medical Assoc Inc | Dermatology | 4727 Hoen Ave Ste A, Santa Rosa, CA 95405-7898 | 2019-07-22 |
| 1427509959 | Northern California Medical Assoc Inc | Dermatology | 555 S Dora St Ste B, Ukiah, CA 95482-5424 | 2016-10-19 |
| 1275945958 | Northern California Medical Assoc Inc | Dermatology | 1165 South Dora St, Ste G2, Ukiah, CA 95482-6353 | 2014-05-29 |
| 1225330459 | Northern California Medical Assoc Inc | Internal Medicine | 153 W Spruce St, Fort Bragg, CA 95437-3024 | 2010-11-19 |
| 1245492321 | Northern California Medical Assoc Inc | Podiatrist | 1701 4th St Ste 100, Santa Rosa, CA 95404 | 2008-06-30 |
| 1548262926 | Northern California Medical Assoc Inc | Internal Medicine | 558 3rd St W, Sonoma, CA 95476-6502 | 2005-08-15 |
| 1174525554 | Northern California Medical Assoc Inc | Internal Medicine | 84 Madrone St, Willits, CA 95490-4249 | 2005-08-15 |
| 1760481204 | Northern California Medical Assoc Inc | Internal Medicine | 4702 Hoen Ave, Santa Rosa, CA 95405-7824 | 2005-07-18 |
| 1073512661 | Northern California Medical Assoc Inc | Internal Medicine | 717 Center St, Healdsburg, CA 95448-3604 | 2005-07-18 |
| Street Address |
719 SOUTHPOINT BLVD STE B |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-1495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891793741 | Raymond Edward Erny | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| 1861852964 | Sport & Spine Therapy of Marin Inc | Physical Therapist | 719 Southpoint Blvd, Suite A, Petaluma, CA 94954-1495 | 2016-03-02 |
| 1003280801 | Next Level Physical Therapy Inc. | Physical Therapist | 719 Southpoint Blvd, Suite A, Petaluma, CA 94954-1495 | 2015-11-17 |
| 1912085523 | Sheryl Anne Garrett | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2006-11-01 |
| 1851338537 | Keith F. Korver, M.d., Inc. | Surgery | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-8003 | 2006-06-01 |
| 1992797435 | Noel E Santo Domingo | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-08-19 |
| 1669470522 | Richard Foster Gaston | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| 1518965490 | Kenneth Lewis Lehrman | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891793741 | Raymond Edward Erny | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| 1982893582 | Adamane S Lalith Mohan | Internal Medicine | 108 Lynch Creek Way, Suite 3, Petaluma, CA 94954-2357 | 2007-10-18 |
| 1689726481 | J. David Judge | Internal Medicine | 3900 Lakeville Hwy, Petaluma, CA 94954-5698 | 2007-01-18 |
| 1912085523 | Sheryl Anne Garrett | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2006-11-01 |
| 1366559486 | A.s.lalith Mohan M.d. Prof. Inc | Internal Medicine | 108 Lynch Creek Way, #3, Petaluma, CA 94954 | 2006-08-24 |
| 1992797435 | Noel E Santo Domingo | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-08-19 |
| 1669470522 | Richard Foster Gaston | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| 1518965490 | Kenneth Lewis Lehrman | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962000141 | Suman S Kuppahally, M.d. Inc | Internal Medicine | 2505 Samaritan Dr Ste 600, San Jose, CA 95124-4017 | 2020-10-11 |
| 1336754472 | Ankur Gupta Medical Corporation | Internal Medicine | 820 S Akers St Ste 130, Visalia, CA 93277-8346 | 2020-09-15 |
| 1295351740 | Penciu Medical Apmc | Internal Medicine | 1585 Sierra Madre Villa Ave, Pasadena, CA 91107-1259 | 2020-06-21 |
| 1679113336 | La Pulse Medical, Inc | Internal Medicine | 14558 Sylvan St Ste 105, Van Nuys, CA 91411-2324 | 2020-01-10 |
| 1770122871 | John R. Nelson M.d. Inc. | Internal Medicine | 7061 N Whitney Ave Ste 101, Fresno, CA 93720-8025 | 2020-01-06 |
| 1730725789 | Norcal Medical Services, Inc | Internal Medicine | 2267 Lava Ridge Ct, Roseville, CA 95661-3062 | 2019-11-25 |
| 1932750957 | Enloe Medical Center | Internal Medicine | 1430 Esplanade Ste 6, Chico, CA 95926-3366 | 2019-09-20 |
| 1528610425 | Nicholas Russell | Internal Medicine | 2967 N Moorpark Rd, Thousand Oaks, CA 91360-4573 | 2019-07-10 |
| 1043871627 | Gy Medical Clinic Inc | Internal Medicine | 7400 Van Nuys Blvd Ste 112, Van Nuys, CA 91405-1972 | 2019-06-25 |
| 1902465792 | Pacific Heart & Vascular | Internal Medicine | 1234 W. Chapman Ave, Ste #101, Orange, CA 92868-2862 | 2019-06-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.