MEDICARE: CALIFORNIA THERAPY SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2251C2600X	Cardiopulmonary Physical Therapist
2	2251G0304X	Geriatric Physical Therapist
3	2251N0400X	Neurology Physical Therapist
4	2251S0007X	Sports Physical Therapist
5	2251X0800X	Orthopedic Physical Therapist
6	225200000X	Physical Therapy Assistant
7	225X00000X	Occupational Therapist
8	225XE0001X	Environmental Modification Occupational Therapist
9	225XM0800X	Mental Health Occupational Therapist
10	225XN1300X	Neurorehabilitation Occupational Therapist
11	225XP0019X	Physical Rehabilitation Occupational Therapist
12	225XP0200X	Pediatric Occupational Therapist
13	235Z00000X	Speech-Language Pathologist
14	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1134742364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	12655 W JEFFERSON BLVD FL 4
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-7008
Country	:	US
Telephone Number	:	310-907-9215
Fax Number	:	310-953-3281

Provider Business Practice Location Address
First Line	:	12655 W JEFFERSON BLVD FL 4
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-7008
Country	:	US
Telephone Number	:	310-907-9215
Fax Number	:	310-953-3281

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ZACHARY DAVID PEVNICK
Credential	:	DPT, PT
Telephone Number	:	310-907-9215

Provider Enumeration Date	:	05/21/2020
Last Update Date	:	08/11/2020

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Directions to “CALIFORNIA THERAPY SERVICES LLC ” Practice Location

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