MEDICARE: DREAMWEAVER MEDICAL ASSOCIATES

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	261QP2300X	Primary Care Clinic/Center		CA

General Provider Information

NPI Number	:	1639426067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREAMWEAVER MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	330 W LAS TUNAS DR STE 1
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1213
Country	:	US
Telephone Number	:	626-284-3300
Fax Number	:	626-284-3307

Provider Business Practice Location Address
First Line	:	330 W LAS TUNAS DR STE 1
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1213
Country	:	US
Telephone Number	:	626-284-3300
Fax Number	:	626-284-3307

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	FRANCISCO G RODRIGUEZ
Credential	:	D.O.
Telephone Number	:	626-284-3300

Provider Enumeration Date	:	08/03/2012
Last Update Date	:	07/21/2022

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Directions to “DREAMWEAVER MEDICAL ASSOCIATES ” Practice Location

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