Healthcare Provider Details

I. General information

NPI: 1275848954
Provider Name (Legal Business Name): SNYDER OPTOMETRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S CHAPEL AVE
ALHAMBRA CA
91801-3948
US

IV. Provider business mailing address

22 S CHAPEL AVE
ALHAMBRA CA
91801-3948
US

V. Phone/Fax

Practice location:
  • Phone: 626-282-8493
  • Fax: 626-282-1910
Mailing address:
  • Phone: 626-282-8493
  • Fax: 626-282-1910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT5208TPA
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID L SNYDER
Title or Position: OWNER
Credential: O.D.
Phone: 626-282-8493