# RESTORATIVE SPINE AND PAIN, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588234447
- **Authorized official:** MATTHEW HADILAKSONO DO (PHYSICIAN)
- **Authorized official phone:** (310) 500-7966

## Contact information

- **Practice address:** 1050 LAS TABLAS RD STE 12, TEMPLETON, CA 93465-9480
- **Practice address phone:** (805) 242-1156
- **Mailing address:** 1375 E GRAND AVE STE 103, ARROYO GRANDE, CA 93420-2421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2021
- **Last updated:** 07/28/2021