Provider Demographics
NPI:1225202542
Name:HSIN, KEN (MD)
Entity Type:Individual
Prefix:
First Name:KEN
Middle Name:
Last Name:HSIN
Suffix:
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 1:5536 SULTANA AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2322
Mailing Address - Country:US
Mailing Address - Phone:626-309-9860
Mailing Address - Fax:
Practice Address - Street 1:548 N 13TH AVE
Practice Address - Street 2:#104
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4917
Practice Address - Country:US
Practice Address - Phone:909-985-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112653208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation