Individual provider Active NPI

Peter Demetris Benardis, PHARM.D.

  • Oncology Pharmacist
  • Harbor City, CA
National Provider Identifier
1073684346
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology PharmacistTaxonomy code 1835X0200X
License
RPH 49691 Issued in CA
Practice address
25825 Vermont Ave
Harbor City, CA 90710-3518
Phone
(310) 517-3531
Fax
(310) 517-4050
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Pharmacist 1835X0200X RPH 49691 CA Primary

Addresses

Primary practice location

25825 Vermont Ave
Harbor City, CA 90710-3518

Mailing address

225 W 3Rd St Apt 402
Long Beach, CA 90802-3050
Phone (562) 726-1214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH 49691CAMDOncology Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073684346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W 3RD ST APT 402",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023050",
            "telephone_number": "562-726-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-517-3531",
            "fax_number": "310-517-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENARDIS",
        "first_name": "PETER",
        "middle_name": "DEMETRIS",
        "name_prefix": "Mr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "CA",
            "license": "RPH 49691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.