Healthcare Provider Details

I. General information

NPI: 1275762809
Provider Name (Legal Business Name): CHRISTOPHER EDWARD SNOWDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD # 53
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

3250 WILSHIRE BLVD STE 1711
LOS ANGELES CA
90010-1577
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-3849
  • Fax:
Mailing address:
  • Phone: 323-361-6233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA116247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: