MEDICARE: WAKSMAN PHYSICAL THERAPY INC.

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	174400000X	Specialist	PT-25978	CA

General Provider Information

NPI Number	:	1093872293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAKSMAN PHYSICAL THERAPY INC.

Provider Business Mailing Address
First Line	:	12030 RIVERSIDE DR
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3749
Country	:	US
Telephone Number	:	818-985-2559
Fax Number	:	818-985-4459

Provider Business Practice Location Address
First Line	:	12030 RIVERSIDE DR
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3749
Country	:	US
Telephone Number	:	818-985-2559
Fax Number	:	818-985-4459

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MILANA WAKSMAN
Credential	:	R.P.T.
Telephone Number	:	818-985-2559

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	05/27/2026

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