So Cal Imaging LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

SO CAL IMAGING LLC

Practice address

2075 Hathaway Ave
Westlake Village, CA 91362-5171

Phone

(818) 312-4555

NPI assigned

Nov 29, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Kappico

Title

Member

Phone

(805) 241-0742

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1861962185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 RE THOUSAND OAKS BLVD., #385",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "91362",
            "telephone_number": "818-312-4555",
            "fax_number": "800-915-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 HATHAWAY AVE",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913625171",
            "telephone_number": "818-312-4555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3835 RE Thousand Oaks Blvd., #385",
            "address_purpose": "LOCATION",
            "city": "Westlake Village",
            "state": "CA",
            "postal_code": "91362",
            "country_code": "US",
            "telephone_number": "818-312-4555",
            "fax_number": "800-915-0607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SO CAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "KAPPICO",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "805-241-0742"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.