Individual provider Active NPI

Kasra Abolhosseini, AUD

  • Audiologist
  • Tustin, CA
National Provider Identifier
1083123129
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU3255 Issued in CA
Practice address
12791 Newport Ave Ste 101
Tustin, CA 92780-2785
Phone
(714) 731-6549
Fax
(714) 730-5372
NPI assigned
Sep 20, 2017
Last updated
Sep 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU3255 CA Primary

Addresses

Primary practice location

12791 Newport Ave Ste 101
Tustin, CA 92780-2785

Mailing address

30642 Mirandela LN
Laguna Niguel, CA 92677-2347
Phone (949) 579-0957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180419000703 CA Practitioner - Qualified Audiologist 4688937949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU3255CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Audiology, Apc Audiologist CurrentSince May 26, 2026 Accepting new patients
Hearx West, LLC CurrentSince May 1, 2020 Accepting new patients
Hearx West Inc Past Accepting new patients
Helix Hearing Care (California) Inc Audiologist PastSince May 1, 2018 Accepting new patients

Locations

3545 E Coast Hwy
Corona del Mar, CA 92625
Phone (949) 675-3833

30271 Golden Lantern
Ste B
Laguna Niguel, CA 92677
Phone (949) 614-4564

1601 W 17th St
Ste E2
Santa Ana, CA 92706
Phone (657) 900-4142

12791 Newport Ave
Ste 101
Tustin, CA 92780
Phone (714) 544-1860

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1083123129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30642 MIRANDELA LN",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772347",
            "telephone_number": "949-579-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 NEWPORT AVE STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802785",
            "telephone_number": "714-731-6549",
            "fax_number": "714-730-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOLHOSSEINI",
        "first_name": "KASRA",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU3255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.