Individual
JOHN E EVERETT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2175 ROSALINE AVE, REDDING, CA 96001-2509
(530) 225-6000
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(818) 340-9988
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A8698
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX8690
—
CA
01
—
020A86980
BLUE SHIELD
CA
01
—
P00145700
RAILROAD MEDICARE
CA
Enumeration date
07/19/2006
Last updated
07/08/2007
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