Organization Active NPI

Diva MD

  • Clinic/Center
  • Laguna Hills, CA
National Provider Identifier
1417343690
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DIVA MD
Practice address
23152 Verdugo Dr Ste 102
Laguna Hills, CA 92653-1373
Phone
(949) 694-1357
Fax
(949) 818-2490
NPI assigned
Apr 14, 2015
Last updated
Jun 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Authorized official

Name
Nazanin Mirarefi, LVN
Title
Nurse/Office Manager
Phone
(949) 694-1357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

23152 Verdugo Dr Ste 102
Laguna Hills, CA 92653-1373

Mailing address

23152 Verdugo Dr Ste 102
Laguna Hills, CA 92653-1373
Phone (949) 694-1357

Other names 1

  • Royal SkinHealth Other name

National Provider Directory

National Provider Directory

Locations

23152 Verdugo Dr
Ste 102
Laguna Hills, CA 92653
Phone (949) 694-1357

23183 La Cadena Dr
Ste 103
Laguna Hills, CA 92653
Phone (562) 790-8100

2105 Beverly Blvd
Ste 233
Los Angeles, CA 90057
Phone (213) 413-9695

32241 Camino Capistrano
Ste A105
San Juan Capo, CA 92675
Phone (949) 661-6555

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1417343690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23152 VERDUGO DR STE 102",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531373",
            "telephone_number": "949-694-1357",
            "fax_number": "949-818-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23152 VERDUGO DR STE 102",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531373",
            "telephone_number": "949-694-1357",
            "fax_number": "949-818-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "MIRAREFI",
        "authorized_official_first_name": "NAZANIN",
        "authorized_official_title_or_position": "NURSE/OFFICE MANAGER",
        "authorized_official_telephone_number": "949-694-1357",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal SkinHealth",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.