Healthcare Provider Details

I. General information

NPI: 1013724632
Provider Name (Legal Business Name): JAMES A. SNYDER IDHS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EAGLE RD
ALAMEDA CA
94501-5101
US

IV. Provider business mailing address

131 POWDER RIVER RUN
DUBLIN CA
94568-4321
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-5999
  • Fax:
Mailing address:
  • Phone: 302-344-5443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: