Peninsula Pharmacy
NPI 1710920079 · Community/Retail Pharmacy · San Pedro, CA
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Peninsula Pharmacy is a Community/Retail Pharmacy organization in San Pedro, CA (NPI 1710920079).
Provider details
- NPI number
- 1710920079
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Shahram Elie, President(310) 833-3535
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES 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
Mailing address
Other names (DBA / former)
- Doing business as
- Peninsula Pharmacy
Registry dates
- Enumerated
- 2006-06-14
- Last updated
- 2025-09-19
Frequently asked questions
- What is Peninsula Pharmacy's NPI number?
- Peninsula Pharmacy's National Provider Identifier (NPI) is 1710920079, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Peninsula Pharmacy?
- Peninsula Pharmacy is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Peninsula Pharmacy located?
- Peninsula Pharmacy's practice location on file with NPPES is 1294 W 6th St Ste 100, San Pedro, CA 90731-2997.
- What is Peninsula Pharmacy's phone number?
- The practice phone number listed in the NPPES registry for Peninsula Pharmacy is (310) 833-3535.
- Does Peninsula Pharmacy accept Medicare?
- Peninsula Pharmacy is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Peninsula Pharmacy?
- The authorized official listed on Peninsula Pharmacy's NPPES record is Shahram Elie, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Peninsula Pharmacy's NPI active?
- Yes — Peninsula Pharmacy's NPI (1710920079) is active in the NPPES registry as of the last update on 2025-09-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.