MEDICARE: STIM IT

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1508186099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STIM IT

Provider Business Mailing Address
First Line	:	4811 EUREKA AVE STE G4
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3368
Country	:	US
Telephone Number	:	714-792-2804
Fax Number	:	714-792-2800

Provider Business Practice Location Address
First Line	:	4811 EUREKA AVE STE G4
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3368
Country	:	US
Telephone Number	:	714-792-2804
Fax Number	:	714-792-2800

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. STAN KOLAKOSKY
Credential	:
Telephone Number	:	714-792-2804

Provider Enumeration Date	:	06/07/2010
Last Update Date	:	06/07/2010

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Directions to “STIM IT ” Practice Location

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