Healthcare Provider Details

I. General information

NPI: 1083541841
Provider Name (Legal Business Name): COAST AUDIOLOGY, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 E COAST HWY
CORONA DEL MAR CA
92625-2404
US

IV. Provider business mailing address

3545 E COAST HWY
CORONA DEL MAR CA
92625-2404
US

V. Phone/Fax

Practice location:
  • Phone: 949-675-3833
  • Fax:
Mailing address:
  • Phone: 949-675-3833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KASRA ABOLHOSSEINI
Title or Position: OWNER/AUDIOLOGIST
Credential: AU.D
Phone: 949-579-0957