Provider Demographics
NPI:1629433420
Name:GIRGIS, PETER (PHARMD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:GIRGIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9417 BAYSINGER ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2901
Mailing Address - Country:US
Mailing Address - Phone:310-367-5414
Mailing Address - Fax:
Practice Address - Street 1:9417 BAYSINGER ST
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-2901
Practice Address - Country:US
Practice Address - Phone:310-367-5414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist