Peninsula Professional Services

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PENINSULA PROFESSIONAL SERVICES

Practice address

21200 Beach Blvd
Huntington Beach, CA 92648-5411

Phone

(714) 374-2626

NPI assigned

Sep 26, 2025

Last updated

Sep 26, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jack Ibrahim, ODNPI 1760978571

Title

Optometrist

Phone

(909) 919-6044

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack Ibrahim, OD

  • Optometrist
  • Cedar Hill, TX
  • NPI 1760978571
  Authorized official Same address or phone
• Lillian Truong, OD

  • Optometrist
  • Huntington Beach, CA
  • NPI 1609492552
  NPD
• Quynh Hoa Thi Truong, O.D.

  • Optometrist
  • Huntington Beach, CA
  • NPI 1508932393
  NPD

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

{
    "created_epoch": "1758844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1023981859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21200 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485411",
            "telephone_number": "714-374-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21200 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485411",
            "telephone_number": "714-374-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "909-919-6044",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Pena
• Yliana Penalosa, NP
• Michelle Pendergast
• Penera Podiatry Corporation
• Rebecca Ann Penera, DPM
• Stacy Pensinger
• Pauline Pepek, M.D.
• Richard Peprah, M.D.
• Heidi Dawn Peralta, MPT
• Julie Ann Peralta

• Optometrist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.