MEDICARE: MATTHEW HAMERLY PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1558230698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW HAMERLY PT

Provider Business Mailing Address
First Line	:	25823 VAN LEUVEN ST APT 157
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2554
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	27811 GREENSPOT RD STE A
Second Line	:
City	:	HIGHLAND
State	:	CA
Zip	:	92346-4361
Country	:	US
Telephone Number	:	909-443-4584
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	11/04/2025

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