Luminous Dermatology

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

A118101 Issued in CA

Legal business name

LUMINOUS DERMATOLOGY

Practice address

504 W Pueblo St Ste 203
Santa Barbara, CA 93105-6211

Phone

(805) 682-3329

Fax

(805) 682-3338

NPI assigned

Apr 30, 2015

Organization subpart

Yes

Parent organization

LUMINOUS DERMATOLOGYAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bryan Gammon, MD

Title

President

Phone

(805) 682-3329

Specialties & licenses 1

Addresses

Other names 1

• Precision Dermatopathology Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Luminous Dermatology

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Luminous Dermatology

  • Dermatology Physician
  • Santa Barbara, CA
  • NPI 1609209576
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wanda Sue Kim-Hayes, PA

  • Medical Physician Assistant
  • Santa Barbara, CA
  • NPI 1760718985
  NPD
• Lam Q. Le, PA-C

  • Surgical Physician Assistant
  • Merced, CA
  • NPI 1164824066
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1427435304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W PUEBLO ST STE 202",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931056211",
            "telephone_number": "805-682-3329",
            "fax_number": "805-682-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W PUEBLO ST STE 203",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931056211",
            "telephone_number": "805-682-3329",
            "fax_number": "805-682-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINOUS DERMATOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUMINOUS DERMATOLOGY",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "GAMMON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-682-3329",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "A118101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Dermatopathology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jon Craig Lukas, MFTI
• Amanda Luke
• Lukes Ultimate Comfort Shoes Inc.
• Mia E Lum, MA, MFT
• Ciara Lumaj, ND
• Luminous Dermatology
• Linda Luna-Aguas
• Joseph A. Luna, M.D.
• Maria Luna
• Else-Marie A Lundin, N.P.

• Clinical Medical Laboratory in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.