Individual
MORDO SUCHOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 S ATLANTIC BLVD STE 202, MONTEREY PARK, CA 91754-6706
(213) 483-4500
(213) 483-4522
Mailing address
16260 VENTURA BLVD, SUITE LL-15, ENCINO, CA 91436-2203
(818) 905-1567
(818) 905-7644
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A39778
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0064560
—
CA
05
—
SUR01185F
—
CA
Enumeration date
11/21/2006
Last updated
05/08/2023
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