MEDICARE: DR. CHRISTOPHER JOHN SEVERYN M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	A145377	CA
2	208000000X	Pediatrics Physician	A145377	CA

General Provider Information

NPI Number	:	1568704724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER JOHN SEVERYN M.D., PH.D.

Provider Business Mailing Address
First Line	:	1000 WELCH RD STE 300
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94304-1812
Country	:	US
Telephone Number	:	650-723-5535
Fax Number	:	650-723-5231

Provider Business Practice Location Address
First Line	:	1000 WELCH RD STE 300
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94304-1812
Country	:	US
Telephone Number	:	650-723-5535
Fax Number	:	650-723-5231

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2013
Last Update Date	:	07/09/2020

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