| Dr Matthew Hadilaksono, DO | |
|
1105 Las Tablas Rd Ste D, Templeton, CA 93465-9731 | |
| (805) 550-6689 | |
| (833) 615-2271 |
| Full Name | Dr Matthew Hadilaksono |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine And Rehabilitation |
| Experience | 13 Years |
| Location | 1105 Las Tablas Rd Ste D, Templeton, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205225174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | 20A15470 (California) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 20A15470 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Restorative Spine And Pain Inc | 8426451428 | 2 |
| Entity Name | Integrative Sports And Spine Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245630557 PECOS PAC ID: 7012230212 Enrollment ID: O20141218002535 |
| Entity Name | Restorative Spine And Pain Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588234447 PECOS PAC ID: 8426451428 Enrollment ID: O20210728003210 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Matthew Hadilaksono, DO 128 La Colima, Pismo Beach, CA 93449-2841 Ph: (310) 500-7966 | Dr Matthew Hadilaksono, DO 1105 Las Tablas Rd Ste D, Templeton, CA 93465-9731 Ph: (805) 550-6689 |
Mr. Steve Hodgson, RPT Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 1255 Las Tablas Rd Ste 201, Templeton, CA 93465 Phone: 805-305-3270 | |
Anthony William Sheplay, MD Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1105 Las Tablas Rd, Suite D, Templeton, CA 93465 Phone: 805-434-0781 Fax: 805-434-0489 | |
Mrs. Valerie A Assemi, RPT Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 1255 Las Tablas Rd Ste 201, Templeton, CA 93465 Phone: 805-286-4794 |