Pacific Dermatology Institute
NPI 1740410182ActiveOrganization· Dermatology· Corona, CA
Dermatology in Corona, California, registered in NPPES in July 2009. The authorized official on file is Bradley Pierce Mudge, M.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1740410182 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 20, 2009 |
| Last updated in NPPES | Aug 29, 2025 |
| Certified by provider | Aug 29, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
| Dermatology, Dermatopathology | 207ND0900X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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