Healthcare Provider Details

I. General information

NPI: 1710062336
Provider Name (Legal Business Name): LARRY STEVEN NICHTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7677 CENTER AVE SUITE 401
HUNTINGTON BEACH CA
92647-3074
US

IV. Provider business mailing address

7677 CENTER AVE SUITE 401
HUNTINGTON BEACH CA
92647-3074
US

V. Phone/Fax

Practice location:
  • Phone: 714-902-1100
  • Fax: 714-902-1101
Mailing address:
  • Phone: 714-902-1100
  • Fax: 714-902-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberG39915
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberG39915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: