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Individual
EDWARD MENACHO
Active
Individual
EDWARD MENACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
57027
CA
363AM0700X
Medical Physician Assistant
PA2900
NV
Other
Enumeration date
07/26/2019
Last updated
06/30/2025
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