Healthcare Provider Details

I. General information

NPI: 1851062566
Provider Name (Legal Business Name): SG HOMECARE,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23172 PLAZA POINTE DR STE 240
LAGUNA HILLS CA
92653-1477
US

IV. Provider business mailing address

15602 MOSHER AVE
TUSTIN CA
92780-6427
US

V. Phone/Fax

Practice location:
  • Phone: 949-474-2050
  • Fax: 949-474-4460
Mailing address:
  • Phone: 949-474-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JAY CHARLES WENDT
Title or Position: CEO
Credential:
Phone: 949-474-2050