Peninsula Pharmacy
Peninsula Pharmacy is a healthcare organization registered as Community/Retail Pharmacy in San Pedro, CA, holding Type 2 (organization) NPI 1710920079 since 2006. The authorized official on file is Shahram Elie, President.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1710920079 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Peninsula Pharmacy |
| Other name | <Unavail> |
| Practice address | 1294 W 6TH ST STE 100, San Pedro, CA, 90731 |
| Phone | 3108333535 |
| Fax | 3108339124 |
| Enumeration date | 2006-06-14 |
| Last updated in NPPES | 2025-09-19 |
Authorized official
| Name | Shahram Elie |
|---|---|
| Title | President |
| Phone | 3108333535 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | PHY36626 | CA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHA3662460 | Medicaid | CA | — |
| 1993007 | Other | — | PK |
Copy-ready billing details
Provider: Peninsula Pharmacy NPI: 1710920079 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 1294 W 6TH ST STE 100, San Pedro, CA, 90731
Verify this record
Cross-check NPI 1710920079 against the authoritative CMS record: view Peninsula Pharmacy on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Peninsula Pharmacy?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-09-19.