Healthcare Provider Details

I. General information

NPI: 1033403647
Provider Name (Legal Business Name): CHRISTINE LORI RONGEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 OLD 1ST ST
LIVERMORE CA
94550-2001
US

IV. Provider business mailing address

2602 OLD 1ST ST
LIVERMORE CA
94550-2001
US

V. Phone/Fax

Practice location:
  • Phone: 323-873-4883
  • Fax:
Mailing address:
  • Phone: 323-873-4883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA136255
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: