MEDICARE: ORRENZO SNYDER MD MEDICAL CORPORATION

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	208800000X	Urology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00324940	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770763930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORRENZO SNYDER MD MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	263 PEARSON DR STE 102
Second Line	:
City	:	PORTERVILLE
State	:	CA
Zip	:	93257-3333
Country	:	US
Telephone Number	:	559-772-4301
Fax Number	:	559-772-4302

Provider Business Practice Location Address
First Line	:	263 PEARSON DR STE 102
Second Line	:
City	:	PORTERVILLE
State	:	CA
Zip	:	93257-3333
Country	:	US
Telephone Number	:	559-772-4301
Fax Number	:	559-772-4302

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ORRENZO B SNYDER
Credential	:	MD
Telephone Number	:	801-935-1702

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	01/14/2022

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