Provider Demographics
NPI:1548540586
Name:GILL, JAPJEET (OD)
Entity type:Individual
Prefix:
First Name:JAPJEET
Middle Name:
Last Name:GILL
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 1:445 W POPLAR ST
Mailing Address - Street 2:ATTN: JANA
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95203-2426
Mailing Address - Country:US
Mailing Address - Phone:209-465-5933
Mailing Address - Fax:
Practice Address - Street 1:445 W POPLAR ST
Practice Address - Street 2:ATTN: JANA
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95203-2426
Practice Address - Country:US
Practice Address - Phone:209-465-5933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14249152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist