Healthcare Provider Details

I. General information

NPI: 1063909919
Provider Name (Legal Business Name): CHRISTINA SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 TORRANCE BLVD
TORRANCE CA
90503-4607
US

IV. Provider business mailing address

13400 RIVERSIDE DR STE 102
SHERMAN OAKS CA
91423-2513
US

V. Phone/Fax

Practice location:
  • Phone: 310-540-7676
  • Fax:
Mailing address:
  • Phone: 323-549-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA165453
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: