Juvive Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A107754 Issued in CA

Legal business name

JUVIVE INC

Practice address

366 San Miguel Dr Ste 201
Newport Beach, CA 92660-7810

Phone

(949) 430-0334

Fax

(949) 430-0336

NPI assigned

Oct 17, 2011

Last updated

Apr 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Heidi Goodarzi, MDNPI 1386849958

Title

President

Phone

(949) 412-8450

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Heidi Goodarzi, MD, Inc

  • Dermatology Physician
  • Orange, CA
  • NPI 1689319204

  O20120618000486

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heidi Goodarzi, M.D.

  • Dermatology Physician
  • Orange, CA
  • NPI 1386849958
  Authorized official Same address or phone

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1316222888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 SAN MIGUEL DR STE 201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607810",
            "telephone_number": "949-430-0334",
            "fax_number": "949-430-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 SAN MIGUEL DR STE 201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607810",
            "telephone_number": "949-430-0334",
            "fax_number": "949-430-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUVIVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-17",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "GOODARZI",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-412-8450",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A107754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://pms.ezderm.com/",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "366 San Miguel Dr Ste 201",
            "city": "Newport Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926607810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vera Juncaj
• Thuy Hua Jung, O.D.
• Kelli Junker, DDS
• Joanna Juntila, FNP-BC
• Ronald Allen Jurgensen, DDS
• K. Wensley. Michael MD, PC
• Douglas G Kahn, MD
• Ashton A. Kaidi, M.D.
• Charlotte Suzanne Kalb, AGNP-BC, PMHNP-BC
• Gavin Kam, DPT

• Specialist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.