MEDICARE: CALIFORNIA POST ACUTE LLC

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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1356895130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA POST ACUTE LLC

Provider Business Mailing Address
First Line	:	909 S LAKE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006
Country	:	US
Telephone Number	:	310-763-0993
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 S LAKE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2113
Country	:	US
Telephone Number	:	310-763-0993
Fax Number	:	213-385-0539

Authorized Official
Title or Position	:	CHIEF EXECUTIVE
Name	:	DOV JACOBS
Credential	:
Telephone Number	:	213-369-9941

Provider Enumeration Date	:	08/09/2016
Last Update Date	:	03/25/2026

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Directions to “CALIFORNIA POST ACUTE LLC ” Practice Location

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