Provider Demographics
NPI:1588842892
Name:NESTOR, LARRY (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:NESTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6250 PARIMA ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-2108
Mailing Address - Country:US
Mailing Address - Phone:213-507-3690
Mailing Address - Fax:
Practice Address - Street 1:3740 ATLANTIC AVE
Practice Address - Street 2:STE 100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3440
Practice Address - Country:US
Practice Address - Phone:562-426-7935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG264962080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology