Healthcare Provider Details

I. General information

NPI: 1013099019
Provider Name (Legal Business Name): KENNETH ERIN HOM PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 RIVERGRADE RD STE C110
IRWINDALE CA
91706-1458
US

IV. Provider business mailing address

4900 RIVERGRADE RD STE C110
IRWINDALE CA
91706-1458
US

V. Phone/Fax

Practice location:
  • Phone: 818-941-5766
  • Fax:
Mailing address:
  • Phone: 310-291-9412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49155
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: