Organization
LUMINOUS DERMATOLOGY
Active
Organization
LUMINOUS DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN GAMMON MD (CEO)
(805) 682-6455
Entity
Organization
Contact information
Practice address
504 W PUEBLO ST STE 102, SANTA BARBARA, CA 93105-6211
(805) 682-3329
Mailing address
504 W PUEBLO ST, SUITE 202, SANTA BARBARA, CA 93105-6211
(805) 682-3329
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A118101
CA
Other
Enumeration date
08/15/2013
Last updated
06/11/2019
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