Healthcare Provider Details

I. General information

NPI: 1932031564
Provider Name (Legal Business Name): SG HOMECARE,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4798 N MARTY AVE
FRESNO CA
93722-7843
US

IV. Provider business mailing address

4798 N MARTY AVE
FRESNO CA
93722-7843
US

V. Phone/Fax

Practice location:
  • Phone: 949-474-2050
  • Fax:
Mailing address:
  • Phone: 949-474-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JORGE VARGAS
Title or Position: DIRECTOR, COMPLIANCE & RISK MANAGEM
Credential:
Phone: 714-905-1208