Pacific Medical Associates, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PACIFIC MEDICAL ASSOCIATES, INC.

Practice address

79430 Highway 111
Suite #102
La Quinta, CA 92253-4547

Phone

(760) 625-0569

Fax

(760) 777-4339

NPI assigned

Apr 22, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bradley Pierce Mudge, M.D.NPI 1891764700

Title

President

Phone

(760) 777-4339

Specialties & licenses 1

Addresses

Other names 1

• Desert Valley Primary Care Associates Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley Pierce Mudge, MD

  • Plastic Surgery Physician
  • Newport Beach, CA
  • NPI 1891764700
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1336583285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79430 HIGHWAY 111",
            "address_2": "SUITE #102",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534547",
            "telephone_number": "760-625-0569",
            "fax_number": "760-777-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79430 HIGHWAY 111",
            "address_2": "SUITE #102",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534547",
            "telephone_number": "760-625-0569",
            "fax_number": "760-777-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "MUDGE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "PIERCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-777-4339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Valley Primary Care Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Angel A Paredes
• Anthony S. Parise
• Heather Hana Park, DDS
• Sarah Jane Parker

• All providers in La Quinta, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.