MEDICARE: MARTIN DE LA HUERTA

Medicare Provider Information

General Provider Information

NPI Number	:	1588523674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN DE LA HUERTA

Provider Business Mailing Address
First Line	:	29532 HYPERION ST
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-2775
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	29532 HYPERION ST
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-2775
Country	:	US
Telephone Number	:	619-925-2133
Fax Number	:

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

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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