Individual
VANAJA MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
354 SANTA FE DR, ENCINITAS, CA 92024-5142
(760) 230-2251
Mailing address
PO BOX 230760, ENCINITAS, CA 92023-0760
(760) 230-2251
(760) 230-2253
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA16853
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA16853
—
CA
Enumeration date
09/26/2005
Last updated
01/08/2016
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