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PACIFIC DERMATOLOGY INSTITUTE
NPI 1740410182
Dermatology in Corona, CA

Active since July 20, 2009CLIA Certified · 12 labs
770 MAGNOLIA AVE STE 1H, CORONA, CA 92879(951) 734-8989 Get Directions Write a Review

NPPES record last updated: August 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 7, 2023, Aug 24, 2021, Mar 29, 2020 and 1 more (4 updates tracked since 2018).

About Pacific Dermatology Institute NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC DERMATOLOGY INSTITUTE (NPI 1740410182) is a healthcare organization registered as a dermatology in Corona, California and active in the NPI registry since July 2009. The organization holds 12 active CLIA laboratory certificates, maintains 15 additional practice locations, and lists Bradley Pierce Mudge, President, as its authorized official.

NPPES Registry Identity

NPI1740410182
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePACIFIC DERMATOLOGY INSTITUTE
Location Address770 MAGNOLIA AVE STE 1HCorona, CA 92879-3121
Mailing Address1200 California St Ste 210Redlands, CA 92374-2948 · (909) 693-3424
Phone(951) 734-8989
Organization SubpartNo
Authorized OfficialBradley Pierce MudgePresident · (951) 354-2220
Enumeration DateJuly 20, 2009
Last NPPES UpdateAugust 29, 20254 updates tracked since enumeration
NPPES CertifiedAugust 29, 2025
✔ NPI 1740410182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
770 MAGNOLIA AVE STE 1H, Corona, CA 92879
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Secondary Practice Locations 15

Location 11666 N Waterman AveSan Bernardino, CA 92404-5113 · Phone (909) 886-4965
Location 2585 N Mountain Ave Ste AUpland, CA 91786-8516 · Phone (909) 608-7546
Location 39041 Magnolia Ave Ste 206Riverside, CA 92503-3956 · Phone (951) 354-2220
Location 4255 Terracina Blvd Ste 205CRedlands, CA 92373-4870 · Phone (909) 793-2323
Location 51481 Ford St Ste 102Redlands, CA 92373-3917 · Phone (909) 793-2323
Location 618523 Corwin Rd Ste GApple Valley, CA 92307-2300 · Phone (760) 242-3376
Location 72140 Grand Ave Ste 260Chino Hills, CA 91709-6806 · Phone (909) 464-9800
Location 81801 E Tahquitz Canyon Way Ste 103Palm Springs, CA 92262-7121 · Phone (760) 537-5561 · Fax (760) 537-5564
Location 911340 Mountain View Ave Ste B1Loma Linda, CA 92354-3884 · Phone (909) 918-4000 · Fax (909) 918-4110
Location 1044605 Avenida De Missiones Ste 202Temecula, CA 92592-5001 · Phone (951) 446-1999 · Fax (951) 446-1984
Location 1125405 Hancock Ave Ste 200Murrieta, CA 92562-5978 · Phone (951) 200-2090
Location 1274090 El Paseo Ste 103Palm Desert, CA 92260-4135 · Phone (760) 341-8244
Location 13240 Newport Center Dr Ste 105, Suite 105Newport Beach, CA 92660 · Phone (951) 354-2220 · Fax (951) 354-2218
Location 147281 Dumosa Ave Ste 3Yucca Valley, CA 92284-3781 · Phone (760) 365-7546
Location 1516465 Sierra Lakes Pkwy Ste 275Fontana, CA 92336-1263 · Phone (909) 279-1010

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 14

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D2257957

Pacific Dermatology Institute · Palm Desert, CA
Active · expires Jun 4, 2027
CLIA Number05D2257957
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorEric Y. Sako
Laboratory Phone(760) 341-8244
Laboratory LocationPacific Dermatology Institute74090 El Paseo, Ste 103, Palm Desert, CA 92260
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 05D2324694

Pacific Dermatology Institute · Fontana, CA
Active · expires May 28, 2027
CLIA Number05D2324694
Laboratory TypePhysician Office
Certificate Effective DateMay 29, 2025
Certificate Expiration DateMay 28, 2027
Laboratory DirectorMona Deerwester
Laboratory Phone(909) 279-1010
Laboratory LocationPacific Dermatology Institute16465 Sierra Lakes Pkwy, Ste 275, Fontana, CA 92336
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 05D2166471

Pacific Dermatology Institute · Redlands, CA
Active · expires Oct 22, 2026
CLIA Number05D2166471
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2024
Certificate Expiration DateOctober 22, 2026
Laboratory DirectorDr. Thomas G. Munyon
Laboratory Phone(909) 793-2323
Laboratory LocationPacific Dermatology Institute255 Terracina Blvd, Ste 205C, Redlands, CA 92373
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 05D2170601

Pacific Dermatology Institute · Palm Springs, CA
Active · expires Oct 12, 2026
CLIA Number05D2170601
Laboratory TypePhysician Office
Certificate Effective DateOctober 13, 2024
Certificate Expiration DateOctober 12, 2026
Laboratory DirectorDr. Thomas G. Munyon
Laboratory Phone(760) 537-5561
Laboratory LocationPacific Dermatology Institute1801 E Tahquitz Canyon Way Ste 103, Palm Springs, CA 92262
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 05D2166071

Pacific Dermatology Institute · Murrieta, CA
Active · expires Sep 27, 2026
CLIA Number05D2166071
Laboratory TypePhysician Office
Certificate Effective DateSeptember 28, 2024
Certificate Expiration DateSeptember 27, 2026
Laboratory DirectorDr. Eric Y. Sako
Laboratory Phone(951) 200-2090
Laboratory LocationPacific Dermatology Institute25405 Hancock Ave, Ste 200, Murrieta, CA 92562
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 05D2166469

Pacific Dermatology Institute · Riverside, CA
Active · expires Sep 23, 2026
CLIA Number05D2166469
Laboratory TypePhysician Office
Certificate Effective DateSeptember 24, 2024
Certificate Expiration DateSeptember 23, 2026
Laboratory DirectorEric Y. Sako
Laboratory Phone(951) 354-2220
Laboratory LocationPacific Dermatology Institute9041 Magnolia Ave, Ste 206, Riverside, CA 92503
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ANETTE J LECAIR PA-C
Physician Assistant (Medical)
770 MAGNOLIA AVE STE 1H
CORONA, CA 92879
Riverside County (951) 734-8989

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Dermatology Institute's NPI number?

The NPI number for Pacific Dermatology Institute is 1740410182. It was assigned to this organization in the NPPES registry on July 20, 2009.

Where is Pacific Dermatology Institute located?

Pacific Dermatology Institute is located at 770 Magnolia Ave Ste 1H, Corona, CA 92879. The listed phone number is (951) 734-8989.

What is Pacific Dermatology Institute's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Pacific Dermatology Institute hold CLIA laboratory certificates?

Yes. 12 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Pacific Dermatology Institute was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.