Healthcare Provider Details

I. General information

NPI: 1730566613
Provider Name (Legal Business Name): CHRISTINE ANNE ROYER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 STONY POINT RD STE E
SANTA ROSA CA
95401-4120
US

IV. Provider business mailing address

135 WATERSIDE CIR
SAN RAFAEL CA
94903-2777
US

V. Phone/Fax

Practice location:
  • Phone: 707-525-0211
  • Fax:
Mailing address:
  • Phone: 207-233-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA169502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: