Provider Demographics
NPI:1134965536
Name:A AND S MEDICAL CENTER INC
Entity type:Organization
Organization Name:A AND S MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SUHOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-353-9900
Mailing Address - Street 1:301 W HUNTINGTON DR STE 112
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-3478
Mailing Address - Country:US
Mailing Address - Phone:747-353-9900
Mailing Address - Fax:
Practice Address - Street 1:301 W HUNTINGTON DR STE 112
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3478
Practice Address - Country:US
Practice Address - Phone:747-353-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty