Edward Menacho, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

57027 Issued in CA

Practice address

1845 Business Center Dr Ste 102
San Bernardino, CA 92408-3447

Phone

(909) 957-9921

NPI assigned

Jul 26, 2019

Last updated

Jun 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edward.menacho.p1@direct.pacificpulm.nextgenshare.com

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

• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• El-Bershawi Medical Corp

  dba Pacific Pulmonary Medical Group

  • Critical Care Medicine (Internal Medicine) Physician
  • Riverside, CA
  • NPI 1386813103
  Medicare reassignment
• Healthcare in Action Medical Group

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1881360758
  Medicare reassignment
• Sharwin Tafazoli Inc

  • Physical Medicine & Rehabilitation Physician
  • Seattle, WA
  • NPI 1447806278

  CA

  Medicare reassignment
• Usc Care Medical Group, Inc

  dba Fair Oaks Clinic

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Pacific Professional Surgical Group Inc

  • Trauma Surgery Physician
  • Riverside, CA
  • NPI 1578341608
  NPD (past)
• Usc Family Medicine Inc.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1619011285
  NPD (past)
• Progressive Psychiatric Services, LLC

  • Addiction Psychiatry Physician
  • Las Vegas, NV
  • NPI 1235922295
  NPD (past)

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1760036958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 BUSINESS CENTER DR STE 102",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083447",
            "telephone_number": "909-957-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENACHO",
        "first_name": "EDWARD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-26",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57027",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eddie.menacho@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 1300",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana Laura Melikidse
• Melissa S. Chun, DDS , a Professional Dental Corporation
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• David Earl Melvin
• Narayana G Memula, M.D.
• Robert James Mendes, MA
• Celena Mendez, MS, AMFT
• Dianey Mary Mendez, LVN
• Ernie Mendez
• Genesis G Mendez

• Physician Assistant in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.