Individual provider Active NPI

Kobi Ledor, M.D.

  • Diagnostic Radiology Physician
  • Berkeley, CA
National Provider Identifier
1477790913
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
C41560 Issued in CA
Practice address
55 Vicente Rd
Berkeley, CA 94705-1603
Phone
(510) 845-3121
Fax
(510) 898-0900
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036.124462 IL
Diagnostic Radiology Physician 2085R0202X 144004-1 NY
Diagnostic Radiology Physician 2085R0202X MD436949 PA
Diagnostic Radiology Physician 2085R0202X C41560 CA Primary

Addresses

Primary practice location

55 Vicente Rd
Berkeley, CA 94705-1603

Mailing address

55 Vicente Rd
Berkeley, CA 94705-1603
Phone (510) 845-3121

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

LicenseStateTypeSpecialty
C41560CAMDDiagnostic Radiology Physician
036.124462ILMDDiagnostic Radiology Physician
144004-1NYMDDiagnostic Radiology Physician
MD436949PAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1477790913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 VICENTE RD",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051603",
            "telephone_number": "510-845-3121",
            "fax_number": "510-898-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 VICENTE RD",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051603",
            "telephone_number": "510-845-3121",
            "fax_number": "510-898-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDOR",
        "first_name": "KOBI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.124462",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "144004-1",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD436949",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C41560",
            "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 Oct 13, 2009; 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.