Provider Demographics
NPI:1679160931
Name:CULTURE OF LIFE FAMILY SERVICES
Entity type:Organization
Organization Name:CULTURE OF LIFE FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARICAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:619-518-8072
Mailing Address - Street 1:362 W MISSION AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-1738
Mailing Address - Country:US
Mailing Address - Phone:760-741-1224
Mailing Address - Fax:760-741-7010
Practice Address - Street 1:362 W MISSION AVE STE 105
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1738
Practice Address - Country:US
Practice Address - Phone:760-741-1224
Practice Address - Fax:760-741-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty