Healthcare Provider Details

I. General information

NPI: 1073990446
Provider Name (Legal Business Name): DREAM SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8907 WILSHIRE BLVD
BEVERLY HILLS CA
90211-1937
US

IV. Provider business mailing address

PO BOX 7001
TARZANA CA
91357-7001
US

V. Phone/Fax

Practice location:
  • Phone: 310-820-2111
  • Fax:
Mailing address:
  • Phone: 818-888-7815
  • Fax: 818-715-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA124202
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER LANE GRAVES
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 214-908-0723