Healthcare Provider Details

I. General information

NPI: 1417197997
Provider Name (Legal Business Name): SAETRUM OPGAARD MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9191 WESTMINSTER AVE STE 207
GARDEN GROVE CA
92844-2751
US

IV. Provider business mailing address

PO BOX 12259
WESTMINSTER CA
92685-2259
US

V. Phone/Fax

Practice location:
  • Phone: 714-786-5794
  • Fax: 714-786-5799
Mailing address:
  • Phone: 949-228-6387
  • Fax: 714-786-5799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: OLE SAETRUM OPGAARD
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 949-228-6387