Provider Demographics
NPI:1053855940
Name:SHERGILL OPTOMETRY INC
Entity Type:Organization
Organization Name:SHERGILL OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BALJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERGILL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-682-2572
Mailing Address - Street 1:7981 E STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-9606
Mailing Address - Country:US
Mailing Address - Phone:916-682-2572
Mailing Address - Fax:916-682-3056
Practice Address - Street 1:7981 E STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-9606
Practice Address - Country:US
Practice Address - Phone:916-682-2572
Practice Address - Fax:916-682-3056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10165T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty