MEDICARE: STERLING PATHOLOGY MED CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CLF11783	OTHER		CA LAB LICENSE

General Provider Information

NPI Number	:	1467444893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STERLING PATHOLOGY MED CORP

Provider Business Mailing Address
First Line	:	3020 OLD RANCH PKWY
Second Line	:	SUITE 300
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2765
Country	:	US
Telephone Number	:	562-799-5518
Fax Number	:	562-799-5544

Provider Business Practice Location Address
First Line	:	3020 OLD RANCH PKWY
Second Line	:	SUITE 300
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2765
Country	:	US
Telephone Number	:	562-799-5518
Fax Number	:	562-799-5544

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CHENGGAO YANG
Credential	:
Telephone Number	:	562-799-5518

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	08/22/2020

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Directions to “STERLING PATHOLOGY MED CORP ” Practice Location

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