Organization
SGH REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFAN G HUMPHRIES MD (OWNER)
(509) 844-8960
Entity
Organization
Contact information
Practice address
38600 MEDICAL CENTER DR, PALMDALE, CA 93551-4483
(509) 844-8960
Mailing address
PO BOX 872, AGOURA HILLS, CA 91376-0872
(818) 518-7226
(818) 671-2225
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C158938
MEDICAL LICENSE
CA
Enumeration date
10/19/2018
Last updated
10/19/2018
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