Organization
PENINSULA PHARMACY
Active
Organization
PENINSULA PHARMACY
Active
Other names
PENINSULA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHRAM ELIE RPH (PRESIDENT)
(310) 833-3535
Entity
Organization
Contact information
Practice address
1294 W 6TH ST STE 100, SAN PEDRO, CA 90731-2997
(310) 833-3535
(310) 833-9124
Mailing address
1294 W 6TH ST STE 100, SAN PEDRO, CA 90731
(310) 833-3535
(310) 833-9124
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY36626
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1993007
PK
—
05
—
PHA3662460
—
CA
Enumeration date
06/14/2006
Last updated
09/19/2025
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