Provider Demographics
NPI:1861503716
Name:RISKIN, RONALD MORRIS (LAC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:MORRIS
Last Name:RISKIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:891 PASEO FERRELO
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2131
Mailing Address - Country:US
Mailing Address - Phone:805-963-1189
Mailing Address - Fax:805-963-1189
Practice Address - Street 1:206 W ANAPAMU ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3605
Practice Address - Country:US
Practice Address - Phone:805-963-9429
Practice Address - Fax:805-963-1189
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3129171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist