Individual
DR. ZACHARY DAVID PEVNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
12655 W JEFFERSON BLVD FL 4, LOS ANGELES, CA 90066-7008
(310) 907-9215
(310) 953-3281
Mailing address
12655 W JEFFERSON BLVD FL 4, LOS ANGELES, CA 90066-7008
(310) 907-9215
(310) 953-3281
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
36828
CA
2251G0304X
Geriatric Physical Therapist
Primary
36828
CA
2251S0007X
Sports Physical Therapist
36828
CA
2251X0800X
Orthopedic Physical Therapist
36828
CA
261QP2000X
Physical Therapy Clinic/Center
36828
CA
Other
Enumeration date
08/27/2010
Last updated
07/10/2020
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