PENINSULA PHARMACY
NPI 1710920079
Pharmacy - Community/Retail Pharmacy in San Pedro, CA

Active since June 14, 2006
1294 W 6TH ST STE 100, SAN PEDRO, CA 90731(310) 833-3535(310) 833-9124 Get Directions Write a Review

NPPES record last updated: September 19, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 19, 2025, Jul 19, 2018, Jun 26, 2018 and 2 more (5 updates tracked since 2016).

About Peninsula Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENINSULA PHARMACY (NPI 1710920079) is a healthcare organization registered as a community/retail pharmacy in San Pedro, California and active in the NPI registry since June 2006. The organization lists Shahram Elie, President, as its authorized official.

NPPES Registry Identity

NPI1710920079
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NamePENINSULA PHARMACY
Location Address1294 W 6TH ST STE 100San Pedro, CA 90731-2997
Mailing Address1294 W 6th St Ste 100San Pedro, CA 90731 · (310) 833-3535 · Fax (310) 833-9124
Fax(310) 833-9124
Organization SubpartNo
Authorized OfficialShahram EliePresident · (310) 833-3535
Enumeration DateJune 14, 2006
Last NPPES UpdateSeptember 19, 20255 updates tracked since enumeration
NPI 1710920079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in CA · PHY36626
Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedPharmacyTaxonomy 333600000X
1294 W 6TH ST STE 100, San Pedro, CA 90731

Other Names 1

Doing Business AsPeninsula Pharmacy

Other Identifiers 2

MedicaidPHA3662460CA
Other1993007Pk

Accepted Insurance

Medical Equipment Supplier Medicare DMEPOS

Medicare supplier enrollment and the product categories Peninsula Pharmacy carries, from the Medicare DMEPOS supplier directory.

Peninsula Pharmacy

DMEPOS supplier · San Pedro, CA

Accepts Medicare assignment

Peninsula Pharmacy agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20651105
Medicare Participant SinceJanuary 1, 1998
Supplier Location1294 W. 6th. Street Suite 100San Pedro, CA 90731
Supplier Specialties
Pharmacy

Medicare Product Categories

Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peninsula Pharmacy's NPI number?

The NPI number for Peninsula Pharmacy is 1710920079. It was assigned to this organization in the NPPES registry on June 14, 2006.

Where is Peninsula Pharmacy located?

Peninsula Pharmacy is located at 1294 W 6th St Ste 100, San Pedro, CA 90731. The listed phone number is (310) 833-3535.

What is Peninsula Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Peninsula Pharmacy accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Peninsula Pharmacy accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Peninsula Pharmacy accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 49 other insurers list Peninsula Pharmacy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Peninsula Pharmacy was last updated on September 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.