Provider Demographics
NPI:1083978027
Name:PERRIN, MEREDITH A (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:A
Last Name:PERRIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:A
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:334 S PATTERSON AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2475
Mailing Address - Country:US
Mailing Address - Phone:805-964-1514
Mailing Address - Fax:805-964-0861
Practice Address - Street 1:334 S PATTERSON AVE STE 105
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2475
Practice Address - Country:US
Practice Address - Phone:805-964-1514
Practice Address - Fax:805-964-0861
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143933207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB259630Medicare PIN