Healthcare Provider Details

I. General information

NPI: 1316948110
Provider Name (Legal Business Name): NORMAN SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 14TH ST STE 109
RIVERSIDE CA
92501-4083
US

IV. Provider business mailing address

2020 IOWA AVE HA103
RIVERSIDE CA
92507-2417
US

V. Phone/Fax

Practice location:
  • Phone: 951-276-7500
  • Fax: 951-276-7522
Mailing address:
  • Phone: 951-781-2270
  • Fax: 951-787-6628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA22921
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: