Healthcare Provider Details

I. General information

NPI: 1932271970
Provider Name (Legal Business Name): JASON CAMERON SNIBBE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 01/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8436 W 3RD ST STE 800
LOS ANGELES CA
90048-4100
US

IV. Provider business mailing address

8436 W 3RD ST STE 800
LOS ANGELES CA
90048-4100
US

V. Phone/Fax

Practice location:
  • Phone: 310-860-3048
  • Fax: 310-550-7680
Mailing address:
  • Phone: 310-860-3048
  • Fax: 310-550-7680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA83463
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: