# ASTROENTEROLOGY ASSOCIATES OF SOUTHERN CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487866646
- **Authorized official:** MORDO SUCHOV M.D. (MANAGING PARTNER)
- **Authorized official phone:** (213) 483-5940

## Contact information

- **Practice address:** 880 S. ATLANTIC BLVD., SUITE G-10, MONTEREY PARK, CA 91754
- **Practice address phone:** (213) 483-5940
- **Practice address fax:** (231) 483-9084
- **Mailing address:** 201 S. ALVARADO ST., SUITE 707, LOS ANGELES, CA 90057-2320
- **Mailing address phone:** (213) 483-5940
- **Mailing address fax:** (213) 483-9084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0064560 | — | CA |