Provider Demographics
NPI:1427386390
Name:DREAMWEAVER CONSULTANCY, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:DREAMWEAVER CONSULTANCY, A MEDICAL CORPORATION
Other - Org Name:SAN GABRIEL VALLEY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:626-296-9500
Mailing Address - Street 1:420 W LAS TUNAS DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1268
Mailing Address - Country:US
Mailing Address - Phone:626-296-9500
Mailing Address - Fax:626-296-9505
Practice Address - Street 1:420 W LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1268
Practice Address - Country:US
Practice Address - Phone:626-296-9500
Practice Address - Fax:626-296-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1922292267Medicaid