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Lincoln Mackey Snyder

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NPI Number Detailed Information

Provider Information:

Name: Lincoln Mackey Snyder
Gender: M
Provider License Number If Given: G56505

NPI Information:

NPI: 1801895180
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/19/2005

Last Update Date: 7/15/2013

Provider Business Mailing Address:

Address: 510 SUPERIOR AVE SUITE 200 G
Newport Beach, CA 92663
Phone Number: 9497916767
Fax Number: 9497916768

Provider Business Practice Location Address:

Address: 510 SUPERIOR AVE SUITE 200 G
Newport Beach, CA 92663
Phone Number: 9497916767
Fax Number: 9497916768

Provider Taxonomy:

Primary: 208600000X
Secondary (if any): 2086X0206X
State: CA

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