Provider Demographics
NPI:1639127566
Name:SNYDER, PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 CAPISTRANO AVE
Mailing Address - Street 2:STE D
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-7201
Mailing Address - Country:US
Mailing Address - Phone:805-466-5600
Mailing Address - Fax:
Practice Address - Street 1:9700 EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5569
Practice Address - Country:US
Practice Address - Phone:805-461-9000
Practice Address - Fax:805-461-9001
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44222207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A442220Medicaid
CAP000944721OtherMEDICARE- RAILROAD
CAP000944721OtherMEDICARE- RAILROAD
CAEW476ZMedicare PIN