Individual
PAUL TABLADILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
100 W CALIFORNIA BLVD, PASADENA, CA 91105-3010
(626) 397-5111
(818) 889-9801
Mailing address
29255 HILLRISE DR, AGOURA HILLS, CA 91301-1533
(818) 437-6121
(818) 889-9801
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95021313
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95021313
CA BRN
CA
Enumeration date
11/14/2022
Last updated
06/12/2023
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