Individual
BRENT B SAETRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5000 HOPYARD ROAD, PLEASANTON, WA 94588
(925) 251-6917
(925) 924-0506
Mailing address
10184 NE GARIBALDI LOOP, BAINBRIDGE ISLAND, UT 98110
(206) 855-4778
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K4994
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164394-04
—
TX
01
—
8F9287
BC/BS PROVIDER NUMBER
TX
01
—
930116427
RAILROAD MEDICARE PROV #
TX
Enumeration date
01/21/2006
Last updated
07/09/2007
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