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General NPI Number Information
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NPI Number | 1568185874
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Entity Type | Organization
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Legal Business Name | SG HOMECARE,INC.
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 1530 S SINCLAIR ST
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City | ANAHEIM
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State | CA
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Zip | 92806-5933
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Country | US
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Telephone | 949-474-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 15602 MOSHER AVE
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City | TUSTIN
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State | CA
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Zip | 92780-6427
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Country | US
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Telephone | 949-474-2050
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Fax | 949-474-4460
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Authorized Official
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Title or Position | CEO
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Name | JAY CHARLES WENDT
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Credential |
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Telephone | 949-474-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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