Provider Demographics
NPI:1033403647
Name:RONGEY, CHRISTINE LORI (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LORI
Last Name:RONGEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 OLD 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-2001
Mailing Address - Country:US
Mailing Address - Phone:323-873-4883
Mailing Address - Fax:
Practice Address - Street 1:2602 OLD 1ST ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-2001
Practice Address - Country:US
Practice Address - Phone:323-873-4883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA136255208D00000X, 208D00000X
WV26901207ZP0102X
PAMT199964390200000X
CT1.061545207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program