Active NPI
Gabriella Kellerman, M.D
- General Practice Physician
- Berkeley, CA
National Provider Identifier
1326244765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A106017
- Practice address
- 984 Oxford St
Berkeley, CA 94707-2435 - Phone
- (617) 270-8255
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A106017 | CA | Primary |
Addresses
Primary practice location
984 Oxford St
Berkeley, CA 94707-2435
Mailing address
984 Oxford St
Berkeley, CA 94707-2435
Phone (617) 270-8255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A106017 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334534400000",
"number": "1326244765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "984 OXFORD ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947072435",
"telephone_number": "617-270-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "984 OXFORD ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947072435",
"telephone_number": "617-270-8255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLERMAN",
"first_name": "GABRIELLA",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2012-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A106017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.