Provider Demographics
NPI:1407128804
Name:SARKA CERNOSEK, MD, INC., A MEDICAL CORP.
Entity Type:Organization
Organization Name:SARKA CERNOSEK, MD, INC., A MEDICAL CORP.
Other - Org Name:S.C. PATHOLOGY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CERNOSEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-803-0390
Mailing Address - Street 1:22214 EVENING STAR CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91390-5765
Mailing Address - Country:US
Mailing Address - Phone:661-297-3613
Mailing Address - Fax:661-310-0478
Practice Address - Street 1:22214 EVENING STAR CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91390-5765
Practice Address - Country:US
Practice Address - Phone:661-297-3613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-31
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFV569AMedicare PIN