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Humberto Enrique De La Torre Hogan

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1505 E Sunnyslope Ln, Phoenix, AZ 85020-2728

PECOS Enrollment

This provider is enrolled in PECOS as HUMBERTO DE LA TORRE HOGAN.

Based on the most recent information from CMS, provider Humberto Enrique De La Torre Hogan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1649161027
Provider Type
Individual
Full Name
De La Torre Hogan, Humberto Enrique

Sole Proprietor
Yes
Enumeration Date
7/14/2025
Last Updated
7/14/2025

Contact Information

Practice Location

1505 E Sunnyslope Ln, Phoenix, AZ 85020-2728

(602) 628-4015

Unlisted Fax

Mailing Location

1505 E Sunnyslope Ln, Phoenix, AZ 85020-2728

(602) 628-4015

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Humberto Enrique De La Torre Hogan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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