Individual
DR. CORWYN ALFRED MOSIMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
386 S GREEN VALLEY RD, WATSONVILLE, CA 95076-3099
(831) 724-1063
(831) 724-1067
Mailing address
386 S GREEN VALLEY RD, WATSONVILLE, CA 95076-3099
(831) 724-1063
(831) 724-1067
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 7532 TPA
CA
152WC0802X
Corneal and Contact Management Optometrist
OPT 7532 TPA
CA
152WL0500X
Low Vision Rehabilitation Optometrist
OPT 7532 TPA
CA
152WP0200X
Pediatric Optometrist
OPT 7532 TPA
CA
152WS0006X
Sports Vision Optometrist
OPT 7532 TPA
CA
152WV0400X
Vision Therapy Optometrist
OPT 7532 TPA
CA
152WX0102X
Occupational Vision Optometrist
OPT 7532 TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396787214
GROUP NPI
CA
Enumeration date
07/27/2005
Last updated
08/02/2011
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