| NPI | 1740410182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY PIERCE MUDGE President 951-354-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2023-07-07 |