| Matthew Kilthau Md Medical Corporation | |
|
956 Walnut St Ste 200 San Luis Obispo CA 93401-1707 | |
| (805) 203-6474 | |
| Not Available |
| Full Name | Matthew Kilthau Md Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 956 Walnut St Ste 200, San Luis Obispo, California |
| Authorized Official Name and Position | Matthew Kilthau (PRESIDENT) |
| Authorized Official Contact | 8052036474 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Kilthau Md Medical Corporation 302 Washington St # 150-5243 San Diego CA 92103-2110 Ph: () - | Matthew Kilthau Md Medical Corporation 956 Walnut St Ste 200 San Luis Obispo CA 93401-1707 Ph: (805) 203-6474 |
| NPI Number | 1457867053 |
|---|---|
| Provider Enumeration Date | 12/18/2017 |
| Last Update Date | 04/01/2025 |
| Certification Date | 04/01/2025 |
| Medicare PECOS PAC ID | 8820353808 |
|---|---|
| Medicare Enrollment ID | O20250506000559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457867053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Matthew Kilthau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831456151 PECOS PAC ID: 2062726490 Enrollment ID: I20191218002579 |
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