Active NPI
Ivan Diamond, M.D.
- Neurology Physician
- Berkeley, CA
National Provider Identifier
1972905768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- G13931
- Practice address
- 761 San Diego Rd
Berkeley, CA 94707-2025 - Phone
- (510) 914-2556
- NPI assigned
- Sep 23, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | G13931 | CA | Primary |
Addresses
Primary practice location
761 San Diego Rd
Berkeley, CA 94707-2025
Mailing address
761 San Diego Rd
Berkeley, CA 94707-2025
Phone (510) 914-2556
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G13931 | CA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411430400000",
"number": "1972905768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "761 SAN DIEGO RD",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947072025",
"telephone_number": "510-914-2556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "761 SAN DIEGO RD",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947072025",
"telephone_number": "510-914-2556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAMOND",
"first_name": "IVAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-23",
"last_updated": "2014-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "G13931",
"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 Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.