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Devin Reed Mudge, MD
Specialist in San Bernardino, California
NPI 1194750778

Devin Reed Mudge is a Specialist based in San Bernardino, CA. Devin Reed Mudge practices in San Bernardino, CA and has the professional credentials of MD. The NPI Number for Devin Reed Mudge is 1194750778 and holds a License No. G75287 (California).

The current practice location address for Devin Reed Mudge is 401 E Highland Ave, San Bernardino, CA and can be reached out via phone at 909-881-1614 and via fax at 909-881-2711.

Location: 401 E Highland Ave, San Bernardino, CA, 92404-3803
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194750778
Provider Name
Devin Reed Mudge
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
401 E Highland Ave, San Bernardino, CA, 92404-3803
Phone Number
909-881-1614
Fax Number
909-881-2711
Provider Enumeration Date
07/11/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00G752871 01 MEDICARE INDIVIDUAL PTAN
00G752870 05 CA
G75287 01 CA LICENSE
ZZZ07161Z 01 MEDICARE GROUP PTAN
institution
Provider Business Practice Location Address Details
Address
401 E Highland Ave
City
San Bernardino
State
California
Zip
92404-3803
Phone Number
909-881-1614
Fax Number
909-881-2711
person
Provider Business Mailing Address Details
Address
401 E Highland Ave
City
San Bernardino
State
California
Zip
92404-3803
Phone Number
909-881-1614
Fax Number
909-881-2711
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
G75287 (California)
Definition
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.
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