Organization Active NPI

Penasquitos Pharmacy

Doing business as Penasquitos Pharmacy Inc

  • Community/Retail Pharmacy
  • San Diego, CA
National Provider Identifier
1568473155
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PENASQUITOS PHARMACY
Doing business as
Penasquitos Pharmacy Inc
Practice address
9917 Carmel Mountain Rd
San Diego, CA 92129-2813
Phone
(858) 484-2880
NPI assigned
Aug 10, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Richard Burdenholzer, RPH
Title
Owner Pharmacist
Phone
(858) 484-2880

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY32769 CA
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

9917 Carmel Mountain Rd
San Diego, CA 92129-2813

Mailing address

9917 Carmel Mountain Rd
San Diego, CA 92129-2813

Other identifiers 2

IdentifierTypeStateIssuer
0570110OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PHA327690MedicaidCA

Other names 1

  • PENASQUITOS PHARMACY INC Doing business as

National Provider Directory

National Provider Directory

Locations

9917 Carmel Mountain Rd
San Diego, CA 92129
Phone (858) 484-2880

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1568473155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9917 CARMEL MOUNTAIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9917 CARMEL MOUNTAIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813",
            "telephone_number": "858-484-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENASQUITOS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BURDENHOLZER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "858-484-2880",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY32769",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0570110",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA327690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENASQUITOS PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.