Lido Surgical Institute, LTD.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LIDO SURGICAL INSTITUTE, LTD.

Practice address

320 Superior Ave Ste 180
Newport Beach, CA 92663-2782

Phone

(949) 645-9995

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Amy Bandy, D.O.

Title

Owner

Phone

(949) 645-9995

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1992846299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SUPERIOR AVE STE 180",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632782",
            "telephone_number": "949-645-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SUPERIOR AVE STE 180",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632782",
            "telephone_number": "949-645-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDO SURGICAL INSTITUTE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "BANDY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-645-9995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZH3073A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "03 00 N LI ZZZH3073A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Licavoli, R.D.
• Jay P. Lichman, M.D.
• Amber Licona
• Lido Pharmacy LLC
• Lido Pharmacy LLC
• Lido TMS Center LLC
• Lido Wellness Center
• Corey Michael Lieber, MD
• Kevin J. Lien, M.D.
• Kristina Lieu

• Ambulatory Surgical Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.