Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Daniel Elkins Boucher, MD

Individual provider Family Medicine Physician · NPI 1164115549

Dr. Daniel Elkins Boucher, MD is a Family Practice in Clearlake, California. Graduated from Loma Linda University School of Medicine in 2023, 3 years ago. Licensed in California.

Years since qualifying
3
Trained at
Loma Linda University School of Medicine
Licensed in
CA
In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

15230 Lakeshore Dr
Clearlake, CA 95422-8107
Phone: (707) 995-4500
Fax: (707) 994-2401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A208143 (CA)

Record details

NPI number1164115549
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 31, 2023
Last updated in NPPESJuly 2, 2026
Certification dateJuly 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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