Individual provider Active NPI

David Luis Snyder, O.D.

  • Optometrist
  • Alhambra, CA
National Provider Identifier
1770540650
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 5208 TPA Issued in CA
Practice address
22 S Chapel Ave
Alhambra, CA 91801-3948
Phone
(626) 282-8493
Fax
(626) 282-1910
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 5208 TPA CA Primary

Addresses

Primary practice location

22 S Chapel Ave
Alhambra, CA 91801-3948

Mailing address

250 S Orange Dr
Los Angeles, CA 90036-3011

Other identifiers 1

IdentifierTypeStateIssuer
SD0052081MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100830000871 CA Practitioner - Optometry 4385768209 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 5208 TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Snyder Optometry, Inc. Optometrist CurrentSince May 9, 2010 Accepting new patients

Locations

22 S Chapel Ave
Alhambra, CA 91801
Phone (626) 282-8493

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1770540650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S ORANGE DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S CHAPEL AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013948",
            "telephone_number": "626-282-8493",
            "fax_number": "626-282-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "DAVID",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 5208 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0052081",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

Verify at the official NPI Registry.