Individual
MR. QUINCY EUGENE MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15693 CHOCTAW ST, VICTORVILLE, CA 92395-5531
(442) 229-2100
(442) 229-2100
Mailing address
15693 CHOCTAW ST, VICTORVILLE, CA 92395-5531
(442) 229-2100
(442) 229-2100
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
361800175
CA
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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