Provider Demographics
NPI:1922505353
Name:PAUL A. SNYDER O.D., INC.
Entity Type:Organization
Organization Name:PAUL A. SNYDER O.D., INC.
Other - Org Name:OAKBROOK OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:805-497-7373
Mailing Address - Street 1:2125 E THOUSAND OAKS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2945
Mailing Address - Country:US
Mailing Address - Phone:805-497-7373
Mailing Address - Fax:805-492-0034
Practice Address - Street 1:2125 E THOUSAND OAKS BLVD STE A
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2945
Practice Address - Country:US
Practice Address - Phone:805-497-7373
Practice Address - Fax:805-492-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12005152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty