| Northern California Medical Assoc Inc | |
|
45081 Little Lake St Mendocino CA 95460 | |
| (707) 573-6166 | |
| (707) 573-6165 |
| Full Name | Northern California Medical Assoc Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 45081 Little Lake St, Mendocino, California |
| Authorized Official Name and Position | Ruth Ann Skidmore (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7075736925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern California Medical Assoc Inc 3536 Mendocino Ave Ste 200 Santa Rosa CA 95403-3634 Ph: (707) 525-6485 | Northern California Medical Assoc Inc 45081 Little Lake St Mendocino CA 95460 Ph: (707) 573-6166 |
| NPI Number | 1982603577 |
|---|---|
| Provider Enumeration Date | 07/18/2005 |
| Last Update Date | 02/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982603577 | NPI | - | NPPES |
| ZZZ01805Z | Other | CA | BLUE SHIELD OF CALIFORNIA |
| GR0001736 | Medicaid | CA |
Jeffrey A Berenson Md A Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45081 Little Lake Street, Mendocino, CA 95460 Phone: 707-937-1055 Fax: 707-937-1061 |