Provider Demographics
NPI:1831455534
Name:SHNAYDERMAN, KYNA Z (MD)
Entity type:Individual
Prefix:
First Name:KYNA
Middle Name:Z
Last Name:SHNAYDERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KYNA
Other - Middle Name:J
Other - Last Name:ZACHARIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4010 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3990
Mailing Address - Country:US
Mailing Address - Phone:888-499-9303
Mailing Address - Fax:714-532-3943
Practice Address - Street 1:4010 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3990
Practice Address - Country:US
Practice Address - Phone:888-499-9303
Practice Address - Fax:714-532-3943
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI66034-20207Q00000X, 208D00000X
IAMD-43603208D00000X
CA169575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice