Provider Demographics
NPI:1508186099
Name:STIM IT
Entity Type:Organization
Organization Name:STIM IT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAKOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-792-2804
Mailing Address - Street 1:4811 EUREKA AVE STE G4
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3368
Mailing Address - Country:US
Mailing Address - Phone:714-792-2804
Mailing Address - Fax:714-792-2800
Practice Address - Street 1:4811 EUREKA AVE STE G4
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3368
Practice Address - Country:US
Practice Address - Phone:714-792-2804
Practice Address - Fax:714-792-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies