Individual
DR. ENRIQUE M. BOQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 VALE TERRACE DR, VISTA, CA 92084-5218
(760) 631-5000
(760) 414-3713
Mailing address
1000 VALE TERRACE DR, VISTA, CA 92084-5218
(760) 631-5000
(760) 414-3713
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C52564
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031511
MICHIGAN STATE LICENSE #
MI
05
—
1013048240
—
MI
01
—
1108211371
BLUE CROSS/BLUE SHIELD
MI
Enumeration date
04/12/2006
Last updated
03/07/2023
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