Provider Demographics
NPI:1316147382
Name:EVERETT, CHARLES KNOX (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:KNOX
Last Name:EVERETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1750 EL CAMINO REAL STE 307
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3216
Mailing Address - Country:US
Mailing Address - Phone:650-697-5367
Mailing Address - Fax:
Practice Address - Street 1:1750 EL CAMINO REAL STE 307
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3216
Practice Address - Country:US
Practice Address - Phone:650-697-5367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98566207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease