Provider Demographics
NPI:1306212261
Name:SNIDER, SAMANTHA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LYNN
Last Name:SNIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 ATLANTIC AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1715
Mailing Address - Country:US
Mailing Address - Phone:562-492-9900
Mailing Address - Fax:
Practice Address - Street 1:2880 ATLANTIC AVE STE 170
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1715
Practice Address - Country:US
Practice Address - Phone:562-492-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA145992208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics