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DEVIN REED MUDGE M.D. NPI 1194750778


NPI Information

NPI: 1194750778
Provider Name: DEVIN REED MUDGE, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
401 E HIGHLAND AVE
SUITE 251
SAN BERNARDINO, CA
ZIP 92404
Phone: (909) 881-1614
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Devin Reed Mudge, M.D. is a specialist in San Bernardino, CA with 39 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Devin Reed Mudge, M.D. NPI is 1194750778. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduation Year:1985

The provider's business location address is:

401 E HIGHLAND AVE
SUITE 251
SAN BERNARDINO, CA
ZIP 92404-803
Phone: (909) 881-1614
Fax: (909) 881-2711

The NPI 1194750778 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 12/2/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistG75287CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G75287OTHERCALIFORNIALICENSE
200G752870MEDICAIDCALIFORNIA
300G752871OTHERMEDICARE INDIVIDUAL PTAN
4ZZZ07161ZOTHERMEDICARE GROUP PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.