Lido Wellness Center

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LIDO WELLNESS CENTER

Practice address

3404 Via Lido
Newport Beach, CA 92663-3968

Phone

(949) 633-2821

NPI assigned

Mar 9, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Collin Weeden

Title

Ceo

Phone

(949) 633-2821

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1477056166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 VIA LIDO # 313",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633908",
            "telephone_number": "949-633-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 VIA LIDO",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633968",
            "telephone_number": "949-633-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDO WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-09",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "WEEDEN",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-633-2821",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Licona
• Lido Pharmacy LLC
• Lido Pharmacy LLC
• Lido Surgical Institute, LTD.
• Lido TMS Center LLC
• Corey Michael Lieber, MD
• Kevin J. Lien, M.D.
• Kristina Lieu
• Eve Elizabeth Lievonen, LCSW
• Life Point Acupuncture, Inc.

• Adult Mental Health Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.