| Northern California Medical Assoc Inc | |
|
506 S Main St Sebastopol CA 95472-4261 | |
| (707) 829-5455 | |
| (707) 824-9235 |
| Full Name | Northern California Medical Assoc Inc |
|---|---|
| Speciality | Neuromusculoskeletal Medicine & Omm |
| Location | 506 S Main St, Sebastopol, California |
| Authorized Official Name and Position | Sally A Dewald (DIRECTOR OF BUSINESS SERVICES) |
| Authorized Official Contact | 7075256485 |
| 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 506 S Main St Sebastopol CA 95472-4261 Ph: (707) 829-5455 |
| NPI Number | 1093229312 |
|---|---|
| Provider Enumeration Date | 11/22/2017 |
| Last Update Date | 11/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093229312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A5942 (California) | Secondary |
| 204D00000X | Neuromusculoskeletal Medicine & Omm | 20A5942 (California) | Primary |
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