Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | A93136 | CA |
NPI | 1154427177 |
---|---|
Provider Name | Dr. Eric Wynne Snyder |
First Address | Encino, CA 91426-0831 |
Second Address | Tarzana, CA 91356-3501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 22/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A931360 | (05) | CA |