Pacific Dermatology Institute

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PACIFIC DERMATOLOGY INSTITUTE

Practice address

770 Magnolia Ave Ste 1H
Corona, CA 92879-3121

Phone

(951) 734-8989

NPI assigned

Jul 20, 2009

Last updated

Aug 29, 2025By the provider in NPPES

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

(951) 354-2220

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Pierce Mudge, MD

  • Plastic Surgery Physician
  • Newport Beach, CA
  • NPI 1891764700
  Medicare reassignment Care Compare group Authorized official
• Ryan C. Donlon, FNP-BC

  • Family Nurse Practitioner
  • Murrieta, CA
  • NPI 1023609401
  Medicare reassignment Care Compare group NPD
• Clemens Esche, M.D.

  • Dermatology Physician
  • Pleasanton, CA
  • NPI 1790826394
  Medicare reassignment Care Compare group NPD
• Vincent Roy Fowler, MD

  • Dermatology Physician
  • Riverside, CA
  • NPI 1548368749
  Medicare reassignment Care Compare group NPD
• Irasema Gonzalez

  • Physician Assistant
  • Huntington Park, CA
  • NPI 1013671882
  Medicare reassignment Care Compare group NPD
• Marie Antoinette Hampton, FNP

  • Family Nurse Practitioner
  • Yucca Valley, CA
  • NPI 1194495440
  Medicare reassignment Care Compare group NPD
• Carmen Huerta, NP-C

  • Nurse Practitioner
  • Murrieta, CA
  • NPI 1871910950
  Medicare reassignment Care Compare group NPD
• Shiva Kheradmand, DO

  • Dermatology Physician
  • Temecula, CA
  • NPI 1457884298
  Medicare reassignment Care Compare group NPD
• Erica E Kim, NP

  • Family Nurse Practitioner
  • Moreno Valley, CA
  • NPI 1124500087
  Medicare reassignment Care Compare group NPD
• Hannah Leone, PA-C

  • Physician Assistant
  • West Covina, CA
  • NPI 1508572785
  Medicare reassignment Care Compare group NPD
• Mona Maghsoodi-Deerwester, MD, M.SC

  • Dermatopathology Physician
  • Redlands, CA
  • NPI 1700377371
  Medicare reassignment Care Compare group NPD
• Thomas George Munyon

  • Dermatology Physician
  • Redwood City, CA
  • NPI 1568481588
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1740410182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CALIFORNIA ST STE 210",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742948",
            "telephone_number": "909-693-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MAGNOLIA AVE STE 1H",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793121",
            "telephone_number": "951-734-8989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1666 N Waterman Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924045113",
            "country_code": "US",
            "telephone_number": "909-886-4965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "585 N Mountain Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917868516",
            "country_code": "US",
            "telephone_number": "909-608-7546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9041 Magnolia Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033956",
            "country_code": "US",
            "telephone_number": "951-354-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 Terracina Blvd Ste 205C",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923734870",
            "country_code": "US",
            "telephone_number": "909-793-2323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1481 Ford St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923733917",
            "country_code": "US",
            "telephone_number": "909-793-2323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18523 Corwin Rd Ste G",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072300",
            "country_code": "US",
            "telephone_number": "760-242-3376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2140 Grand Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917096806",
            "country_code": "US",
            "telephone_number": "909-464-9800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 E Tahquitz Canyon Way Ste 103",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922627121",
            "country_code": "US",
            "telephone_number": "760-537-5561",
            "fax_number": "760-537-5564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11340 Mountain View Ave Ste B1",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923543884",
            "country_code": "US",
            "telephone_number": "909-918-4000",
            "fax_number": "909-918-4110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44605 Avenida De Missiones Ste 202",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925925001",
            "country_code": "US",
            "telephone_number": "951-446-1999",
            "fax_number": "951-446-1984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25405 Hancock Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925625978",
            "country_code": "US",
            "telephone_number": "951-200-2090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "74090 El Paseo Ste 103",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922604135",
            "country_code": "US",
            "telephone_number": "760-341-8244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 Newport Center Dr Ste 105",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "92660",
            "country_code": "US",
            "telephone_number": "951-354-2220",
            "fax_number": "951-354-2218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7281 Dumosa Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Yucca Valley",
            "state": "CA",
            "postal_code": "922843781",
            "country_code": "US",
            "telephone_number": "760-365-7546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16465 Sierra Lakes Pkwy Ste 275",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923361263",
            "country_code": "US",
            "telephone_number": "909-279-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PACIFIC DERMATOLOGY INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-20",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "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": "951-354-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oxygen 2 Go, Inc.
• P. Tiempetpaisal DDS Inc (Soft Care Dental)
• Chricel Marie-Elmore Pace
• Carmela Pacheco
• Delia Ann Pacheco
• Pacific Kare LLC (Acti-Kare Responsive In-Home Care)
• Pacific Medical Supply
• Amelia Grace Gines Padilla, RPH
• Andrea Padilla
• Ariana Padilla

• Dermatology Physician in Corona, CA
• Providers in Corona, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.