MEDICARE: BENJAMIN HUU SIN PTA

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	225200000X	Physical Therapy Assistant	AT11200	CA

General Provider Information

NPI Number	:	1356275077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN HUU SIN PTA

Provider Business Mailing Address
First Line	:	9510 PARKER LN
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-1417
Country	:	US
Telephone Number	:	424-603-8566
Fax Number	:

Provider Business Practice Location Address
First Line	:	5584 N PARAMOUNT BLVD STE 100
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-5149
Country	:	US
Telephone Number	:	562-920-8394
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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