Individual provider Active NPI

Kent Ernest Tesoro, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1356430235
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A70924 Issued in CA
Practice address
2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone
(213) 744-5235
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A70924 CA Primary
Pediatrics Physician 208000000X A70924 CA

Addresses

Primary practice location

2829 S Grand Ave
Los Angeles, CA 90007-3304

Mailing address

521 N Palm Ave Apt B
Alhambra, CA 91801-6543
Phone (626) 458-0442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040216000476 CA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2365337813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Southern California Keck School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians
Healthcare Partners Affiliates Medical GroupGroup PAC ID 7315842002, 775 clinicians

Practice addresses (Care Compare)

2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone (213) 699-7013

797 S Fair Oaks Ave
Pasadena, CA 91105-2617
Phone (626) 795-2244

Hospital & facility affiliations

  • Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A70924CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Feb 29, 2016 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles CurrentSince Feb 29, 2016 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 12, 2016 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Jan 12, 2016 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1025 W Olympic Blvd
Los Angeles, CA 90015
Phone (213) 623-2225

2829 S Grand Ave
Los Angeles, CA 90007
Phone (213) 699-7000

401 S Fair Oaks Ave
Pasadena, CA 91105
Phone (323) 720-1144

797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1356430235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 N PALM AVE APT B",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918016543",
            "telephone_number": "626-458-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073304",
            "telephone_number": "213-744-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESORO",
        "first_name": "KENT",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A70924",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A70924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.