Lisa D. Vidato, M.D., Inc.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G68685 Issued in CA

Legal business name

LISA D. VIDATO, M.D., INC.

Practice address

1328 22ND St
Santa Monica, CA 90404-2032

Phone

(310) 829-8202

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Lisa D. Vidato, M.D.

Title

Owner

Phone

(310) 829-8202

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1871604322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 SAN VICENTE BLVD",
            "address_2": "#440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495131",
            "telephone_number": "310-471-5852",
            "fax_number": "310-471-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 22ND ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042032",
            "telephone_number": "310-829-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA D. VIDATO, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "VIDATO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-829-8202",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G68685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G686850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonard Michael Lipman, M.D.
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• Marla Danielle Lipsyc-Sharf, MD
• Lisa C Moore MD Inc
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• Lisa E Pulver
• Lisa Haas Physical Therapy, Inc.
• Lisa M. Masterson MD a Professional Corporation
• Aaron Lisberg, MD
• Jeanne Lisella, D.C.

• Anesthesiology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.