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1164535001
LISA VIDATO
SANTA MONICA, CA
NPI
1164535001
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: CA G068685)
Enumeration Date
2006-08-16
Last Update Date
2015-08-07
Business Address
-- LISA VIDATO MD
1328 22ND ST
SANTA MONICA, CA 90404-2032
Phone number: 310-681-9996
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Mailing Address
-- LISA VIDATO MD
PO BOX 60790
PASADENA, CA 91116-6790
Phone number: 626-795-6596
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