Provider Demographics
NPI:1700927381
Name:SHERGILL, BALJIT KAUR (OD)
Entity Type:Individual
Prefix:
First Name:BALJIT
Middle Name:KAUR
Last Name:SHERGILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10165T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist