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General NPI Number Information
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NPI Number | 1407128804
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Entity Type | Organization
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Legal Business Name | SARKA CERNOSEK, MD, INC., A MEDICAL CORP.
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 06/22/2017
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Provider Practice Location Address
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Address Line | 22214 EVENING STAR CT
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City | SANTA CLARITA
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State | CA
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Zip | 91390-5765
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Country | US
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Telephone | 661-297-3613
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Fax |
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Provider Business Mailing Address
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Address Line | 22214 EVENING STAR CT
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City | SANTA CLARITA
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State | CA
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Zip | 91390-5765
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Country | US
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Telephone | 661-297-3613
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Fax | 661-310-0478
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Authorized Official
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Title or Position | PRESIDENT
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Name | SARKA CERNOSEK
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Credential | M.D.
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Telephone | 661-803-0390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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