Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G39915 | CA |
N | 208600000X | Surgeon | G39915 | CA |
N | 2082S0105X | Plastic Hand Surgeon | G39915 | CA |
NPI | 1710062336 |
---|---|
Provider Name | Larry Steven Nichter |
First Address | Huntington Beach, CA 92647-3074 |
Second Address | Huntington Beach, CA 92647-3074 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |