Healthcare Provider Details

I. General information

NPI: 1629223201
Provider Name (Legal Business Name): SARKA CERNOSEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2008
Last Update Date: 07/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LE CONTE AVE
LOS ANGELES CA
90095-3075
US

IV. Provider business mailing address

22214 EVENING STAR CT
SANTA CLARITA CA
91390-5765
US

V. Phone/Fax

Practice location:
  • Phone: 310-794-1355
  • Fax:
Mailing address:
  • Phone: 661-297-3613
  • Fax: 661-803-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberA90642
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA90642
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: