Vidato, Lisa

Vidato, Lisa is an individual health care provider with primary practice located at 1328 22Nd St , Santa Monica CA 90404-2032. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Vidato, Lisa can be contacted via phone (310) 681-9996.

Contact Information

Primary practice address
1328 22Nd St Santa Monica CA 90404-2032
Phone: (310) 681-9996
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X G068685 California

Profile Details

NPI number 1164535001
LBN Legal business name Vidato, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated Aug 7th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164535001 NPPES
California MEDICAID 00G68650

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