Provider Demographics
NPI:1235199894
Name:SNYDER, STEVEN VAN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:VAN
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3807
Mailing Address - Country:US
Mailing Address - Phone:714-347-1010
Mailing Address - Fax:714-647-1245
Practice Address - Street 1:361 HOSPITAL RD
Practice Address - Street 2:124
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3522
Practice Address - Country:US
Practice Address - Phone:949-583-9944
Practice Address - Fax:949-583-9955
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49473207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A494731Medicaid
CA050033515OtherRR PTAN
CA00A494731Medicaid
CAA49473Medicare PIN
CABN489ZMedicare PIN