| Edward Menacho, PA | |
|
1845 Business Center Dr Ste 102, San Bernardino, CA 92408-3447 | |
| (909) 957-9921 | |
| Not Available |
| Full Name | Edward Menacho |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1845 Business Center Dr Ste 102, San Bernardino, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760036958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 57027 (California) | Primary |
| 363AM0700X | Physician Assistant - Medical | PA2900 (Nevada) | Secondary |
| Entity Name | Usc Care Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902846306 PECOS PAC ID: 0446157747 Enrollment ID: O20050512000412 |
| Entity Name | El-bershawi Medical Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386813103 PECOS PAC ID: 9032298492 Enrollment ID: O20080509000414 |
| Entity Name | Sharwin Tafazoli Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447806278 PECOS PAC ID: 8729416953 Enrollment ID: O20200320002154 |
| Entity Name | Healthcare in Action Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881360758 PECOS PAC ID: 4981093093 Enrollment ID: O20211111000622 |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Menacho, PA Po Box 31309, Los Angeles, CA 90031-0309 Ph: (323) 442-5900 | Edward Menacho, PA 1845 Business Center Dr Ste 102, San Bernardino, CA 92408-3447 Ph: (909) 957-9921 |
Nicholas Walther, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-883-8711 |
Deval Dave, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-883-8711 |
Daniel E Kim, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 284 E Highland Ave, San Bernardino, CA 92404 Phone: 909-883-1098 Fax: 909-883-0653 |
Ms. Tanisha G Williams, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1805 Medical Center Dr, San Bernardino, CA 92411 Phone: 909-887-6333 Fax: 909-887-1985 |
Miss Sara Natour, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2334 N Sierra Way, San Bernardino, CA 92405 Phone: 909-747-2715 |
Ms. Keturah Braithwaite, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 941 Kendall Dr Ste C, San Bernardino, CA 92407 Phone: 302-354-7476 |
Mr. Richard Tang, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1364 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-474-9952 |