1. Home
  2. Directory
  3. California
  4. Newport Beach
  5. Dermatology
  6. NPI Profile

ISLAND DERMATOLOGY, INC
NPI 1508815556
Dermatology in Newport Beach, CA

Active since May 08, 2006CLIA Certified · 3 labs
360 SAN MIGUEL DR, SUITE 501, NEWPORT BEACH, CA 92660(949) 720-1170(949) 720-1172 Get Directions Write a Review

NPPES record last updated: October 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 21, 2022, Oct 22, 2018, Oct 16, 2018 (3 updates tracked since 2018).

About Island Dermatology, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ISLAND DERMATOLOGY, INC (NPI 1508815556) is a healthcare organization registered as a dermatology in Newport Beach, California and active in the NPI registry since May 2006. The organization holds 3 active CLIA laboratory certificates, maintains a secondary practice location in Hesperia, and lists Navid Nami, Cheif Finacial Officer, as its authorized official.

NPPES Registry Identity

NPI1508815556
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameISLAND DERMATOLOGY, INC
Location Address360 SAN MIGUEL DR, SUITE 501Newport Beach, CA 92660-7853
Mailing Address360 San Miguel Dr, Suite 501Newport Beach, CA 92660-7853 · (949) 720-1170 · Fax (949) 720-1172
Phone(949) 720-1170
Fax(949) 720-1172
Organization SubpartNo
Authorized OfficialNavid NamiCheif Finacial Officer · (949) 720-1170
Enumeration DateMay 8, 2006
Last NPPES UpdateOctober 21, 20223 updates tracked since enumeration
NPPES CertifiedOctober 21, 2022
✔ NPI 1508815556 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
360 SAN MIGUEL DR, Newport Beach, CA 92660
Open in Google Maps ↗

Secondary Practice Location 1

Location 116785 Bear Valley Rd Ste 5Hesperia, CA 92345-0825 · Phone (760) 951-7762 · Fax (760) 951-7134

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D1056357

Island Dermatology · Newport Beach, CA
Active · expires Feb 20, 2027
CLIA Number05D1056357
Laboratory TypePhysician Office
Certificate Effective DateFebruary 21, 2025
Certificate Expiration DateFebruary 20, 2027
Laboratory DirectorLeila Ettefagh MD
Laboratory Phone(949) 720-1170
Laboratory LocationIsland Dermatology360 San Miguel Dr, Ste 501, Newport Beach, CA 92660
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 05D2288775

Island Dermatology Dba Santa Ana Dermatology · Santa Ana, CA
Active · expires Aug 29, 2027
CLIA Number05D2288775
Laboratory TypePhysician Office
Certificate Effective DateAugust 30, 2025
Certificate Expiration DateAugust 29, 2027
Laboratory DirectorLeila Ettefagh
Laboratory Phone(949) 720-1170
Laboratory LocationIsland Dermatology Dba Santa Ana Dermatology2621 S Bristol St Suite 309, Santa Ana, CA 92704
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2293678

Island Dermatology · Laguna Hills, CA
Active · expires May 6, 2027
CLIA Number05D2293678
Laboratory TypePhysician Office
Certificate Effective DateMay 7, 2025
Certificate Expiration DateMay 6, 2027
Laboratory DirectorLeila Ettefagh
Laboratory Phone(949) 720-1170
Laboratory LocationIsland Dermatology24012 Calle De La Plata Ste 200, Laguna Hills, CA 92653
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN M. SCHWAB, M.D., A MEDICAL CORPORATION
Anesthesiology
360 SAN MIGUEL DR, #207
NEWPORT BEACH, CA 92660
Orange County (949) 721-1113
DR. ROBERT GERTMENIAN BURNS M.D.
Surgery
360 SAN MIGUEL DR, SUITE 608
NEWPORT BEACH, CA 92660
Orange County (949) 760-1144
REX C. MOODY D.S.S.
Dentist (Oral and Maxillofacial Surgery)
360 SAN MIGUEL DR, SUITE 402
NEWPORT BEACH, CA 92660
Orange County (949) 760-1600
NEWPORT ANESTHESIA ASSOCIATES
Specialist
360 SAN MIGUEL DR, SUITE 406
NEWPORT BEACH, CA 92660
Orange County (949) 759-0995
CHALINEE JILL INTARACHOTE D.P.T.
Physical Medicine & Rehabilitation
360 SAN MIGUEL DR, 301
NEWPORT BEACH, CA 92660
Orange County (949) 759-0300
MATTHEW O'MAHONEY D.P.T.
Physical Therapist
360 SAN MIGUEL DR, 301
NEWPORT BEACH, CA 92660
Orange County (714) 759-0300
MR. ALI REZA RAFATJOO M.D.
Family Medicine
360 SAN MIGUEL DR, SUITE 206
NEWPORT BEACH, CA 92660
Orange County (949) 640-4455
NICHOLAS ELIAS ROSE M.D.
Orthopaedic Surgery (Hand Surgery)
360 SAN MIGUEL DR, SUITE#701
NEWPORT BEACH, CA 92660
Orange County (949) 759-3600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Island Dermatology, Inc's NPI number?

The NPI number for Island Dermatology, Inc is 1508815556. It was assigned to this organization in the NPPES registry on May 8, 2006.

Where is Island Dermatology, Inc located?

Island Dermatology, Inc is located at 360 San Miguel Dr Suite 501, Newport Beach, CA 92660. The listed phone number is (949) 720-1170.

What is Island Dermatology, Inc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Island Dermatology, Inc hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Island Dermatology, Inc was last updated on October 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.