Provider Demographics
NPI:1194387290
Name:NORTHERN CALIFORNIA ORTHOPAEDIC ASSOCIATES CORP
Entity Type:Organization
Organization Name:NORTHERN CALIFORNIA ORTHOPAEDIC ASSOCIATES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CASK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-512-6262
Mailing Address - Street 1:75 SCRIPPS DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6320
Mailing Address - Country:US
Mailing Address - Phone:916-512-6262
Mailing Address - Fax:
Practice Address - Street 1:1061 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5724
Practice Address - Country:US
Practice Address - Phone:916-512-6262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN CALIFORNIA ORTHOPAEDIC ASSOCIATES CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty