Provider Demographics
NPI:1396539573
Name:STEALTH IMAGING
Entity type:Organization
Organization Name:STEALTH IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPPICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-312-4555
Mailing Address - Street 1:20251 VENTURA BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2571
Mailing Address - Country:US
Mailing Address - Phone:818-312-4555
Mailing Address - Fax:800-915-0607
Practice Address - Street 1:20251 VENTURA BLVD STE D
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2571
Practice Address - Country:US
Practice Address - Phone:888-814-0206
Practice Address - Fax:888-814-0207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology