Individual provider Active NPI

Lisa Bresloff Norton, MD

  • Family Medicine Physician
  • Vista, CA
National Provider Identifier
1720181084
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C159591 Issued in CA
Practice address
134 Grapevine Rd
Vista, CA 92083-4004
Phone
(760) 631-5000
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101238023 VA
Family Medicine Physician 207Q00000X 35121711 OH
Family Medicine Physician 207Q00000X C159591 CA Primary

Addresses

Primary practice location

134 Grapevine Rd
Vista, CA 92083-4004

Mailing address

1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone (760) 631-5000

Other identifiers 1

IdentifierTypeStateIssuer
0104035MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210427000856 CA Order and Referring Only - Family PracticePractitioner - Family Practice 1951526003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C159591CAMDFamily Medicine Physician
0101238023VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1720181084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 GRAPEVINE RD",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920834004",
            "telephone_number": "760-631-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTON",
        "first_name": "LISA",
        "middle_name": "BRESLOFF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101238023",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35121711",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C159591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104035",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.