NPIMap

Individual provider Active NPI

Charles Kerber, MD

  • Vascular & Interventional Radiology Physician
  • La Mesa, CA
National Provider Identifier
1366443533
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
C30735 Issued in CA
Practice address
4444 Topa Topa Dr
La Mesa, CA 91941-7160
Phone
(760) 598-8058
Fax
(760) 598-8078
NPI assigned
Aug 9, 2005
Reactivated
Mar 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X C30735 CA
Vascular & Interventional Radiology Physician 2085R0204X C30735 CA Primary

Addresses

Primary practice location

4444 Topa Topa Dr
La Mesa, CA 91941-7160

Mailing address

4444 Topa Topa Dr
La Mesa, CA 91941-7160
Phone (760) 598-8058

Other identifiers 2

IdentifierTypeStateIssuer
00C307351MedicaidCA
OOC307350OtherCABLUE SHIELD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Ucsd Department of Radiology PastSince May 13, 2014 Accepting new patients
Regents of the University of California Neuroradiology Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1366443533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 TOPA TOPA DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919417160",
            "telephone_number": "760-598-8058",
            "fax_number": "760-598-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 TOPA TOPA DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919417160",
            "telephone_number": "760-598-8058",
            "fax_number": "760-598-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERBER",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-03-11",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "C30735",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "C30735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C307351",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OOC307350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.