Vitruvianmd Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

VITRUVIANMD INC

Practice address

30131 Town Center Dr Ste 295
Laguna Niguel, CA 92677-2086

Phone

(619) 363-5347

Fax

(949) 288-0375

NPI assigned

Sep 1, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Melton Lish, MD

Title

Owner/Ceo

Phone

(559) 308-3017

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1053031716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30131 TOWN CENTER DR STE 295",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772086",
            "telephone_number": "619-363-5347",
            "fax_number": "949-288-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30131 TOWN CENTER DR STE 295",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772086",
            "telephone_number": "619-363-5347",
            "fax_number": "949-288-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITRUVIANMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "LISH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "MELTON",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "559-308-3017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.