Juan Andres Astudillo-Cordova, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A106781 Issued in CA

Practice address

11234 Anderson St
House Staff Office, CP 21005
Loma Linda, CA 92354-2804

Phone

(909) 558-8131

Fax

(909) 558-0430

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1316008378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "HOUSE STAFF OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8131",
            "fax_number": "909-558-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "HOUSE STAFF OFFICE, CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8131",
            "fax_number": "909-558-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASTUDILLO-CORDOVA",
        "first_name": "JUAN",
        "middle_name": "ANDRES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A106781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kettlen Cristh Ataides Borda
• Syed Ahmed Athar, M.D.
• Corinne Atiga, DDS
• Osman Omar Atiq, MD
• Philopatir Joseph Attalla, MD

• Surgery Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.