MEDICARE: DR. BHAVJIT KAUR MANGAT OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG004337	PA
2	152W00000X	Optometrist	OD60911189	WA
3	152W00000X	Optometrist	1514	NH
4	152W00000X	Optometrist	TPOP312	FL

General Provider Information

NPI Number	:	1609346246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHAVJIT KAUR MANGAT OD

Provider Business Mailing Address
First Line	:	4927 S 292ND ST
Second Line	:
City	:	AUBURN
State	:	WA
Zip	:	98001-2845
Country	:	US
Telephone Number	:	253-249-8182
Fax Number	:

Provider Business Practice Location Address
First Line	:	4927 S 292ND ST
Second Line	:
City	:	AUBURN
State	:	WA
Zip	:	98001-2845
Country	:	US
Telephone Number	:	253-249-8182
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2018
Last Update Date	:	02/13/2026

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