Active NPI
Steven Gary Snyder, DPT
- Physical Therapist
- Pomona, CA
National Provider Identifier
1093050056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 39690
- Practice address
- 795 E 2ND St
Suite 4
Pomona, CA 91766-2007 - Phone
- (909) 706-3779
- Fax
- (909) 620-1048
- NPI assigned
- Dec 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 39690 | CA | Primary |
Addresses
Primary practice location
795 E 2ND St
Suite 4
Pomona, CA 91766-2007
Mailing address
795 E 2ND St
Suite 4
Pomona, CA 91766-2007
Phone (909) 706-3779
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT 39690 | Other | CA | CA DPT LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39690 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372809600000",
"number": "1093050056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "795 E 2ND ST",
"address_2": "SUITE 4",
"city": "POMONA",
"state": "CA",
"postal_code": "917662007",
"telephone_number": "909-706-3779",
"fax_number": "909-620-1048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "795 E 2ND ST",
"address_2": "SUITE 4",
"city": "POMONA",
"state": "CA",
"postal_code": "917662007",
"telephone_number": "909-706-3779",
"fax_number": "909-620-1048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNYDER",
"first_name": "STEVEN",
"middle_name": "GARY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-03",
"last_updated": "2013-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "39690",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA DPT LICENSE",
"identifier": "PT 39690",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.