Healthcare Provider Details

I. General information

NPI: 1487519245
Provider Name (Legal Business Name): SHELDON SNYDER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 FOUNTAIN AVE
LOS ANGELES CA
90029-1005
US

IV. Provider business mailing address

5317 SERENE FOREST DR
APEX NC
27539-4129
US

V. Phone/Fax

Practice location:
  • Phone: 323-461-9961
  • Fax:
Mailing address:
  • Phone: 336-750-7476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number310512
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP23808
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: