Basic Information
Provider Information
NPI: 1154675585
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAETERN
FirstName: ANTHONY
MiddleName: SARNFOU
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3400 DATA DR
Address2: PHYSICIAN SUPPORT SERVICES
City: RANCHO CORDOVA
State: CA
PostalCode: 956707956
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7500 HOSPITAL DR
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958235403
CountryCode: US
TelephoneNumber: 9166811866
FaxNumber: 9166811860
Other Information
ProviderEnumerationDate: 11/07/2012
LastUpdateDate: 11/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XA123513CAN Allopathic & Osteopathic PhysiciansFamily Medicine 
208M00000XA123513CAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home