NPIMap

Organization Active NPI

Mordo Suchov MD Inc

  • Gastroenterology Physician
  • Encino, CA
National Provider Identifier
1306073994
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A39778 Issued in CA
Legal business name
MORDO SUCHOV MD INC
Practice address
16260 Ventura Blvd
Suite LL-15
Encino, CA 91436-2203
Phone
(818) 905-1567
Fax
(818) 905-7406
NPI assigned
Jun 22, 2009
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mordo Suchov, MDNPI 1609941301
Title
Owner
Phone
(818) 905-1567

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A39778 CA Primary

Addresses

Primary practice location

16260 Ventura Blvd
Suite LL-15
Encino, CA 91436-2203

Mailing address

16260 Ventura Blvd Ste LL15
Encino, CA 91436-4931
Phone (818) 905-1567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090814000215 CA Part B Supplier - Clinic/Group Practice 8426102112 Receives reassigned benefits from 14 practitioners
Practice locations: Monterey Park, CA

National Provider Directory

National Provider Directory

Locations

16260 Ventura Blvd
Ste LL15
Encino, CA 91436
Phone (818) 582-3427

201 S Alvarado St
Ste 711
Los Angeles, CA 90057
Phone (213) 483-4500

850 S Atlantic Blvd
Ste 202
Monterey Park, CA 91754
Phone (213) 483-4500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1306073994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16260 VENTURA BLVD STE LL15",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364931",
            "telephone_number": "818-905-1567",
            "fax_number": "818-905-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16260 VENTURA BLVD",
            "address_2": "SUITE LL-15",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362203",
            "telephone_number": "818-905-1567",
            "fax_number": "818-905-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORDO SUCHOV MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "SUCHOV",
        "authorized_official_first_name": "MORDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-905-1567",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A39778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.