Organization
LUMINOUS DERMATOLOGY
Active
Parent organization
LUMINOUS DERMATOLOGY
Other names
Precision Dermatopathology
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUMINOUS DERMATOLOGY
Authorized official
BRYAN GAMMON MD (PRESIDENT)
(805) 682-3329
Entity
Organization
Contact information
Practice address
504 W PUEBLO ST STE 203, SANTA BARBARA, CA 93105-6211
(805) 682-3329
(805) 682-3338
Mailing address
504 W PUEBLO ST STE 202, SANTA BARBARA, CA 93105-6211
(805) 682-3329
(805) 682-3338
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
A118101
CA
Other
Enumeration date
04/30/2015
Last updated
09/03/2015
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