| Mordo Suchov MD Inc | |
|
16260 Ventura Blvd Suite Ll-15 Encino CA 91436-2203 | |
| (818) 905-1567 | |
| (818) 905-7406 |
| Full Name | Mordo Suchov MD Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 16260 Ventura Blvd, Encino, California |
| Authorized Official Name and Position | Mordo Suchov (OWNER) |
| Authorized Official Contact | 8189051567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mordo Suchov MD Inc 16260 Ventura Blvd Ste Ll15 Encino CA 91436-4931 Ph: (818) 905-1567 | Mordo Suchov MD Inc 16260 Ventura Blvd Suite Ll-15 Encino CA 91436-2203 Ph: (818) 905-1567 |
| NPI Number | 1306073994 |
|---|---|
| Provider Enumeration Date | 06/22/2009 |
| Last Update Date | 09/08/2025 |
| Certification Date | 09/08/2025 |
| Medicare PECOS PAC ID | 8426102112 |
|---|---|
| Medicare Enrollment ID | O20090814000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306073994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A39778 (California) | Primary |
| Provider Name | Jeng Luen Yuh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952438830 PECOS PAC ID: 1850383456 Enrollment ID: I20040401001831 |
| Provider Name | Maria D Ronquillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518032762 PECOS PAC ID: 4688646318 Enrollment ID: I20040811001422 |
| Provider Name | Mordo Suchov |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609941301 PECOS PAC ID: 7315091006 Enrollment ID: I20090814000377 |
| Provider Name | Dipti Sagar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558642751 PECOS PAC ID: 3274856810 Enrollment ID: I20150106001581 |
| Provider Name | Vlad Gheorghiu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427426618 PECOS PAC ID: 1355645920 Enrollment ID: I20160203000404 |
| Provider Name | Victoria Diane De Felice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134589088 PECOS PAC ID: 1951691047 Enrollment ID: I20160601002511 |
| Provider Name | Kristen Michele Prusa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477120582 PECOS PAC ID: 7719385780 Enrollment ID: I20211005001622 |
| Provider Name | Talin Bourian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679280788 PECOS PAC ID: 3779948054 Enrollment ID: I20230421000372 |
| Provider Name | Ashraf Ah Ashhab |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235581604 PECOS PAC ID: 0941594022 Enrollment ID: I20240820004162 |
| Provider Name | Vanessa Jane Wilson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538757984 PECOS PAC ID: 9436556743 Enrollment ID: I20250918003992 |
| Provider Name | Svetlana Akopian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255139648 PECOS PAC ID: 2365931763 Enrollment ID: I20251027003461 |
| Provider Name | Rachel Shana Sarrafzadeh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467135442 PECOS PAC ID: 1759873821 Enrollment ID: I20251125003638 |
| Provider Name | Maryam Pourjalil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114791910 PECOS PAC ID: 2062993439 Enrollment ID: I20260224001981 |
| Provider Name | Svitlana Bondar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275199705 PECOS PAC ID: 1557842648 Enrollment ID: I20260226001855 |
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