Provider Demographics
NPI:1407744097
Name:TESORERO, PAUL JOHN LOMIBAO (SRNA)
Entity type:Individual
Prefix:MR
First Name:PAUL JOHN
Middle Name:LOMIBAO
Last Name:TESORERO
Suffix:
Gender:M
Credentials:SRNA
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Mailing Address - Street 1:1840 S NELSON ST APT 73
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1498
Mailing Address - Country:US
Mailing Address - Phone:956-639-5543
Mailing Address - Fax:
Practice Address - Street 1:100 S LOS ROBLES AVE # 501
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2453
Practice Address - Country:US
Practice Address - Phone:626-564-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95273267163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse