Healthcare Provider Details
I. General information
NPI: 1548282999
Provider Name (Legal Business Name): WILLIAM JOHN SNAPE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/24/2006
Last Update Date: 12/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2340 CLAY ST 2ND FLOOR
SAN FRANCISCO CA
94115-1932
US
IV. Provider business mailing address
PO BOX 254947
SACRAMENTO CA
95865-4947
US
V. Phone/Fax
- Phone: 415-600-1138
- Fax: 415-600-1122
- Phone: 916-854-6975
- Fax: 916-854-6844
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | G46515 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: