Organization
BRADLEY MUDGE MD INC
Active
Other names
Novare Plastic Surgery and Skin Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY PIERCE MUDGE MD (MEDICAL DIRECTOR)
(949) 644-2450
Entity
Organization
Contact information
Practice address
240 NEWPORT CENTER DR, SUITE 105, NEWPORT BEACH, CA 92660-7512
(949) 644-2450
(949) 644-2451
Mailing address
240 NEWPORT CENTER DR, SUITE 105, NEWPORT BEACH, CA 92660-7512
(949) 644-2450
(949) 644-2451
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A79221
CA
Other
Enumeration date
12/21/2006
Last updated
07/30/2010
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