Individual
MILTON KENNETH MUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N PEPPER AVE, ORTHOPAEDIC ADMINISTRATION, COLTON, CA 92324-1801
(909) 580-6330
(909) 580-6369
Mailing address
400 N PEPPER AVE, ORTHOPAEDIC ADMINISTRATION, COLTON, CA 92324-1801
(909) 580-6330
(909) 580-6369
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A24662
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ24406Z
MEDICARE LOCATION
CA
Enumeration date
01/29/2007
Last updated
04/18/2008
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