OrganizationActive
Provision Pharmacy, Inc.
NPI 1417811647 · Community/Retail Pharmacy · San Diego, CA
Provision Pharmacy, Inc. is a Community/Retail Pharmacy organization in San Diego, CA (NPI 1417811647).
Provider details
- NPI number
- 1417811647
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Alan Chan, Ceo(808) 854-8999
Specialties & taxonomies
Suppliers
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4428 Glacier Ave
San Diego, CA 92120-3304
Phone: (808) 854-8999
Street-level locationGet directions
Mailing address
4428 Glacier Ave
San Diego, CA 92120-3304
Registry dates
- Enumerated
- 2025-12-11
- Last updated
- 2025-12-11
- Certified
- 2025-12-11
Frequently asked questions
- What is Provision Pharmacy, Inc.'s NPI number?
- Provision Pharmacy, Inc.'s National Provider Identifier (NPI) is 1417811647, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Provision Pharmacy, Inc.?
- Provision Pharmacy, Inc. is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Provision Pharmacy, Inc. located?
- Provision Pharmacy, Inc.'s practice location on file with NPPES is 4428 Glacier Ave, San Diego, CA 92120-3304.
- What is Provision Pharmacy, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Provision Pharmacy, Inc. is (808) 854-8999.
- Who is the authorized official for Provision Pharmacy, Inc.?
- The authorized official listed on Provision Pharmacy, Inc.'s NPPES record is Alan Chan, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Provision Pharmacy, Inc.'s NPI active?
- Yes — Provision Pharmacy, Inc.'s NPI (1417811647) is active in the NPPES registry as of the last update on 2025-12-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.