Individual provider Active NPI

Bennie-John Milan, PA-C

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1093258956
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
54020 Issued in CA
Practice address
3800 Kilroy Airport Way Ste 100
Long Beach, CA 90806-6818
Phone
(213) 669-6453
NPI assigned
Nov 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 54020 CA Primary

Addresses

Primary practice location

3800 Kilroy Airport Way Ste 100
Long Beach, CA 90806-6818

Mailing address

8352 Hazeltine Ave
Panorama City, CA 91402-3758
Phone (818) 974-1915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170504001363 CA Practitioner - Physician Assistant 6800173626 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54020CAMDMarriage & Family Therapist

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1093258956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8352 HAZELTINE AVE",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023758",
            "telephone_number": "818-974-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 KILROY AIRPORT WAY STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908066818",
            "telephone_number": "213-669-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILAN",
        "first_name": "BENNIE-JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-28",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.