Provider Demographics
NPI:1699882365
Name:HEREDIA-MARTINEZ, HECTOR JR (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:HEREDIA-MARTINEZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 JOSHUA CREEK PL
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-2600
Mailing Address - Country:US
Mailing Address - Phone:619-426-1010
Mailing Address - Fax:619-426-1010
Practice Address - Street 1:401 H ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4321
Practice Address - Country:US
Practice Address - Phone:619-420-1010
Practice Address - Fax:619-420-1010
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50069208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice