Provider Demographics
NPI:1568704724
Name:SEVERYN, CHRISTOPHER JOHN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:SEVERYN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:SEVERYN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:1000 WELCH RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1812
Mailing Address - Country:US
Mailing Address - Phone:650-723-5535
Mailing Address - Fax:650-723-5231
Practice Address - Street 1:1000 WELCH RD STE 300
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1812
Practice Address - Country:US
Practice Address - Phone:650-723-5535
Practice Address - Fax:650-723-5231
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA145377207RH0003X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology