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Organization

LIDO SURGICAL INSTITUTE, LTD.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AMY BANDY D.O. (OWNER)
(949) 645-9995
Entity
Organization

Contact information

Practice address
320 SUPERIOR AVE STE 180, NEWPORT BEACH, CA 92663-2782
(949) 645-9995
Mailing address
320 SUPERIOR AVE STE 180, NEWPORT BEACH, CA 92663-2782
(949) 645-9995

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03 00 N LI ZZZH3073A
BLUE SHIELD
CA
01
ZZZH3073A
BLUE SHIELD
CA
Enumeration date
02/09/2007
Last updated
07/28/2010
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