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General NPI Number Information
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NPI Number | 1952915068
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Entity Type | Organization
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Legal Business Name | PIMPLE POPPER MD, INC.
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Dates
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Enumeration Date | 09/04/2020
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Last Update Date | 09/12/2020
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Provider Practice Location Address
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Address Line | 601 E ARRELLAGA ST STE 101
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City | SANTA BARBARA
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State | CA
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Zip | 93103-2275
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Country | US
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Telephone | 805-944-1130
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Fax | 805-244-2568
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Provider Business Mailing Address
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Address Line | 1669 LAS CANOAS RD
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City | SANTA BARBARA
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State | CA
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Zip | 93105-2364
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Country | US
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Telephone | 661-993-2479
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Fax | 805-244-2568
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | RIKK LYNN
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Credential | MD
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Telephone | 805-944-1130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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