MEDICARE: DR. SAMANTHA LYNN SNIDER M.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	208000000X	Pediatrics Physician	A145992	CA

General Provider Information

NPI Number	:	1306212261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMANTHA LYNN SNIDER M.D.

Provider Business Mailing Address
First Line	:	2880 ATLANTIC AVE STE 170
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1715
Country	:	US
Telephone Number	:	562-492-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 ATLANTIC AVE STE 170
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1715
Country	:	US
Telephone Number	:	562-492-9900
Fax Number	:

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

Provider Enumeration Date	:	08/14/2015
Last Update Date	:	12/08/2020

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