Individual
EDWARD MENACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1845 BUSINESS CENTER DR STE 102, SAN BERNARDINO, CA 92408-3447
(909) 957-9921
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5900
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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