MEDICARE: DOMINIQUE ENRIQUEZ

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	183500000X	Pharmacist	85553	CA

General Provider Information

NPI Number	:	1396499927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIQUE ENRIQUEZ

Provider Business Mailing Address
First Line	:	1888 COBBLECREEK ST
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91913-3917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 PALM AVE
Second Line	:
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1529
Country	:	US
Telephone Number	:	619-424-8989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2022
Last Update Date	:	02/11/2022

Similar Medicare Providers

1013951375 — GARFIELD BEACH CVS LLC
Practice Location Address:

800 PALM AVE
IMPERIAL BEACH, CA
91932-1529

Practice Phone: 619-424-8989
Practice Fax:

1326289737 — SADEEQ KHAN SADIQ, INC.
Practice Location Address:

888 PALM AVE
IMPERIAL BEACH, CA
91932-1529

Practice Phone: 619-423-0100
Practice Fax: 619-423-0120

1245603018 — JASON OH PHARM.D.
Practice Location Address:

800 PALM AVE
IMPERIAL BEACH, CA
91932-1529

Practice Phone: 619-424-8989
Practice Fax: 619-424-9614

1003674508 — DR. FADY ZAKKO PHARMD
Practice Location Address:

800 PALM AVE
IMPERIAL BEACH, CA
91932-1529

Practice Phone: 619-424-8989
Practice Fax:

1730933003 — VERONICA CUEVAS PHARMD
Practice Location Address:

800 PALM AVE
IMPERIAL BEACH, CA
91932-1529

Practice Phone: 619-424-8989
Practice Fax:

1588925689 — MRS. CORINNE ELISABETH SCOTT
Practice Location Address:

814 IMPERIAL WAY
BAYPORT, NY
11705-1529

Practice Phone: 516-769-5026
Practice Fax:

Directions to “ DOMINIQUE ENRIQUEZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.