Healthcare Provider Details

I. General information

NPI: 1639127566
Provider Name (Legal Business Name): PATRICIA SNYDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 EL CAMINO REAL SUITE 100
ATASCADERO CA
93422-5569
US

IV. Provider business mailing address

5855 CAPISTRANO AVE STE D
ATASCADERO CA
93422-7201
US

V. Phone/Fax

Practice location:
  • Phone: 805-461-9000
  • Fax: 805-461-9001
Mailing address:
  • Phone: 805-466-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA44222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: