MEDICARE: DR. PAUL ALAN SNYDER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	12005	CA

General Provider Information

NPI Number	:	1063502730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL ALAN SNYDER O.D.

Provider Business Mailing Address
First Line	:	2125 E THOUSAND OAKS BLVD
Second Line	:	SUITE A
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-2942
Country	:	US
Telephone Number	:	805-497-7373
Fax Number	:

Provider Business Practice Location Address
First Line	:	2125 E THOUSAND OAKS BLVD
Second Line	:	SUITE A
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-2942
Country	:	US
Telephone Number	:	805-497-7373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	12/27/2012

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