Organization
ASTROENTEROLOGY ASSOCIATES OF SOUTHERN CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MORDO SUCHOV M.D. (MANAGING PARTNER)
(213) 483-5940
Entity
Organization
Contact information
Practice address
880 S. ATLANTIC BLVD., SUITE G-10, MONTEREY PARK, CA 91754
(213) 483-5940
(231) 483-9084
Mailing address
201 S. ALVARADO ST., SUITE 707, LOS ANGELES, CA 90057-2320
(213) 483-5940
(213) 483-9084
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0064560
—
CA
Enumeration date
05/03/2007
Last updated
08/22/2020
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