Provider Demographics
NPI:1013645084
Name:GLENN SNYDERS, MD, PC
Entity Type:Organization
Organization Name:GLENN SNYDERS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:757-408-1656
Mailing Address - Street 1:3514 HARWICH DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-7065
Mailing Address - Country:US
Mailing Address - Phone:757-408-1656
Mailing Address - Fax:
Practice Address - Street 1:3501 JAMBOREE RD STE 1200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2904
Practice Address - Country:US
Practice Address - Phone:949-988-7888
Practice Address - Fax:949-988-7889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty