Organization
PACIFIC DERMATOLOGY INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY PIERCE MUDGE M.D. (PRESIDENT)
(951) 354-2220
Entity
Organization
Contact information
Practice address
770 MAGNOLIA AVE STE 1H, CORONA, CA 92879-3121
(951) 734-8989
Mailing address
1200 CALIFORNIA ST STE 210, REDLANDS, CA 92374-2948
(909) 693-3424
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
Other
Enumeration date
07/20/2009
Last updated
08/29/2025
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