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General NPI Number Information
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NPI Number | 1720171259
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Entity Type | Individual
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Provider Name | ORRENZO BENALLY SNYDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 263 PEARSON DR STE 100
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City | PORTERVILLE
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State | CA
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Zip | 93257-3333
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Country | US
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Telephone | 559-772-4301
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Fax | 559-772-4302
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Provider Business Mailing Address
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Address Line | 263 PEARSON DR STE 100
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City | PORTERVILLE
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State | CA
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Zip | 93257-3333
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Country | US
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Telephone | 559-772-4301
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Fax | 559-772-4302
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | C172411
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 6844039-1205
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License Number State | UT
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