NORTHERN CALIFORNIA MEDICAL ASSOC INC (NPI# 1649279233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649279233 |
| Entity Type | Organization |
| Organization Name | NORTHERN CALIFORNIA MEDICAL ASSOC INC |
| Practice Address |
46900 Ocean Dr Gualala CA 95445-8353 |
| Mailing Address |
3536 Mendocino Ave Ste 200 Santa Rosa CA 95403-3634 |
| Practice Telephone | 7075736166 |
| Practice Fax Number | 7075736165 |
| Mailing Telephone | 7075256485 |
| Mailing Fax Number | 7075736918 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2015-07-09 |
| 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 | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD OF CALIFORNIA | ZZZ36940Z | 01 |
| CA | GR000173B | 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 |
46900 OCEAN DR |
| City | GUALALA |
| State | CA |
| Zip Code | 95445-8353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558707968 | Adele Zita | Registered Nurse | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2013-05-13 |
| 1407030968 | Jefferson Nerney | Psychologist | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2007-12-19 |
| 1093833659 | Jere Alm | Physician Assistant | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2007-03-26 |
| 1164555769 | Leon Koenck | Physician Assistant | 46900 Ocean Dr, Ste 1100, Gualala, CA 95445-8353 | 2007-03-13 |
| 1962530725 | Redwood Coast Medical Services, Inc. | Clinic/Center | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2007-03-01 |
| 1952494817 | Joanne C. Brooks | Family Medicine | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2006-10-02 |
| 1346332335 | Lois Falk | Nurse Practitioner | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2006-09-28 |
| 1780776682 | Roberta U. Rams | Dentist | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2006-09-28 |
| 1851379705 | Elizabeth J Nagle | Nurse Practitioner | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2006-01-01 |
| 1316937931 | Mark Kal | Family Medicine | 46900 Ocean Dr, Gualala, CA 95445-8353 | 2005-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205453586 | Mendocino Pharmacy Holdings Inc. | Pharmacy | 39251 South Highway 1, Gualala, CA 95445 | 2020-07-02 |
| 1922659499 | Lucinda Weaver Physical Therapy | Clinic/Center | 39120 Ocean Dr, Gualala, CA 95445 | 2019-09-25 |
| 1275858573 | James Edwin Platt | Chiropractor | 38820 Hwy. 1, Suite 108, Gualala, CA 95445 | 2010-03-30 |
| 1184862013 | Lucinda Weaver I | Physical Therapist | 39120 Ocean Dr., Gualala, CA 95445 | 2009-01-30 |
| 1902050669 | Gena Lynn Davis | Optometrist | 39150 Ocean Drive, Suite 2a, Gualala, CA 95445 | 2008-11-07 |
| 1477731032 | Carolee Brady | Marriage & Family Therapist | 38550 S Hwy 1, Gualala, CA 95445 | 2008-02-06 |
| 1053432971 | Barbara Brittell | Physician Assistant | 46900 Ocean Drive, Redwood Coast Medical Services, Gualala, CA 95445 | 2007-04-02 |
| 1174658298 | Richard T Miner | Chiropractor | 38690 Pacific Dr., Suite 3, Gualala, CA 95445 | 2007-02-22 |
| 1104962638 | Robert Arnold Nelson | Ophthalmology | 30150 So Hwy One, Gualala, CA 95445 | 2007-01-30 |
| 1982808119 | Allen B. Cox Jr. | Dentist | 38460 S. Highway One, Gualala, CA 95445-1199 | 2007-06-12 |
| Find all providers in zip 95445 | ||||
| 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. |
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| 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.