Provider Demographics
NPI:1912079864
Name:SNIDER, PAUL NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:NORMAN
Last Name:SNIDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27965 ROBLE BLANCO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-2413
Mailing Address - Country:US
Mailing Address - Phone:650-941-0223
Mailing Address - Fax:650-948-4641
Practice Address - Street 1:27965 ROBLE BLANCO
Practice Address - Street 2:
Practice Address - City:LOS ALTOS HILLS
Practice Address - State:CA
Practice Address - Zip Code:94022
Practice Address - Country:US
Practice Address - Phone:650-941-0223
Practice Address - Fax:650-948-4641
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG245602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AS6063666OtherDEA CERTIFICATION
AS6063666OtherDEA CERTIFICATION
00G245600Medicare ID - Type Unspecified