=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780250266
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARBJIT MEHMI OD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2021
-----------------------------------------------------
Last Update Date | 09/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8246 LAGUNA BLVD STE 300
-----------------------------------------------------
City | ELK GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95758-7972
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-684-6688
-----------------------------------------------------
Fax | 916-684-6721
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8246 LAGUNA BLVD STE 300
-----------------------------------------------------
City | ELK GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95758-7972
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-684-6688
-----------------------------------------------------
Fax | 916-684-6721
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OPC5959
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 0618003098
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 36125TLG
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------