Individual provider Active NPI

Liane Christine Tongol, PA-C

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1447817309
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA56817 Issued in CA
Practice address
625 Lincoln Ave
San Jose, CA 95126-3785
Phone
(408) 871-5260
NPI assigned
May 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA56817 CA Primary

Addresses

Primary practice location

625 Lincoln Ave
San Jose, CA 95126-3785

Mailing address

5174 Zinfandel LN
Vallejo, CA 94591-6329
Phone (707) 319-8128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191001002316 CA Practitioner - Physician Assistant 4880924034 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

125 W Hungtington Dr
Arcadia, CA 91007-3050

1450 San Pablo St
Los Angeles, CA 90033-4500

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

300 W Hungtington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA56817CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jan 6, 2024 Accepting new patients
Alameda Health System CurrentSince Feb 28, 2023 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jan 6, 2024 Accepting new patients
Stanford Health Care CurrentSince Oct 1, 2020 Accepting new patients
Alameda Health System CurrentSince Feb 28, 2023 Accepting new patients
Stanford Health Care CurrentSince Oct 1, 2020 Accepting new patients
El Camino Health Medical Group Past Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

125 W Huntington Dr
Bldg A
Arcadia, CA 91007
Phone (626) 574-2710

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1518 San Pablo St
Ste 3500
Los Angeles, CA 90033

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

1520 San Pablo St
Lowr
Los Angeles, CA 90033
Phone (323) 442-7450

1450 San Pablo St
Ste 6200
Los Angeles, CA 90033
Phone (323) 442-7920

1441 Eastlake Ave
Los Angeles, CA 90089
Phone (323) 865-3000

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

625 S Fair Oaks Ave
Ste 400
Pasadena, CA 91105
Phone (626) 568-1622

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1447817309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5174 ZINFANDEL LN",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945916329",
            "telephone_number": "707-319-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 LINCOLN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263785",
            "telephone_number": "408-871-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONGOL",
        "first_name": "LIANE CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.