Active NPI
Stephen Thomas Hom, PHARM.D.
- Pharmacist
- San Diego, CA
National Provider Identifier
1063847523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 69603
- Practice address
- 4647 Zion Ave
San Diego, CA 92120-2507 - Phone
- (619) 528-6491
- NPI assigned
- Sep 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 69603 | CA | Primary |
Addresses
Primary practice location
4647 Zion Ave
San Diego, CA 92120-2507
Mailing address
6426 Ambrosia Dr
Apt. #5312
San Diego, CA 92124-3112
Phone (760) 217-9250
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
| License | State | Type | Specialty |
|---|---|---|---|
| 69603 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Veta Pharmacy LLC | Current | Accepting new patients | |
| Lido Pharmacy LLC | Current | Accepting new patients | |
| Lido Pharmacy LLC | Current | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Newport Lido Pharmacy
- Community/Retail Pharmacy
- Newport Beach, CA
- NPI 1164550885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378166400000",
"number": "1063847523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6426 AMBROSIA DR",
"address_2": "APT. #5312",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921243112",
"telephone_number": "760-217-9250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4647 ZION AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921202507",
"telephone_number": "619-528-6491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOM",
"first_name": "STEPHEN",
"middle_name": "THOMAS",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-03",
"last_updated": "2013-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "69603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.