Organization Active NPI

Hassan a Kobaissi DPM

  • Foot & Ankle Surgery Podiatrist
  • Hacienda Heights, CA
National Provider Identifier
1245632777
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4235 Issued in CA
Legal business name
HASSAN A KOBAISSI DPM
Practice address
3180 Colima Rd
Suite a
Hacienda Heights, CA 91745-6315
Phone
(626) 961-1882
Fax
(626) 968-7599
NPI assigned
Sep 16, 2014
Last updated
Mar 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Authorized official

Name
Hassan A Kobaissi, M.D.NPI 1932209624
Title
Ceo
Phone
(626) 961-1882

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4235 CA Primary

Addresses

Primary practice location

3180 Colima Rd
Suite a
Hacienda Heights, CA 91745-6315

Mailing address

3180 Colima Rd
Suite a
Hacienda Heights, CA 91745-6315
Phone (626) 961-1882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150626000440 CA Part B Supplier - Clinic/Group Practice 2264743657 Receives reassigned benefits from 4 practitioners
Practice locations: Hacienda Heights, CA
O20171002000774 CA DME Supplier - Physician - Podiatry 2264743657 Practice locations: Hacienda Heights, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0906280Hassan a Kobaissi, DPM3180 Colima Rd, Ste a, Hacienda Heights, CA 91745Provider-performed microscopySep 8, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1245632777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 COLIMA RD",
            "address_2": "SUITE A",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456315",
            "telephone_number": "626-961-1882",
            "fax_number": "626-968-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 COLIMA RD",
            "address_2": "SUITE A",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456315",
            "telephone_number": "626-961-1882",
            "fax_number": "626-968-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HASSAN A KOBAISSI DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "KOBAISSI",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-961-1882",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hacienda Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.