Individual
DR. COURTNEY KASSEBAUM BOVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5655 E LA PALMA AVE STE 150, ANAHEIM, CA 92807-2122
(714) 340-0520
Mailing address
5655 E LA PALMA AVE STE 150, ANAHEIM, CA 92807-2122
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 15011 TLG
CA
152WC0802X
Corneal and Contact Management Optometrist
OPT 15011 TLG
CA
152WP0200X
Pediatric Optometrist
OPT 15011 TLG
CA
152WS0006X
Sports Vision Optometrist
OPT 15011 TLG
CA
152WX0102X
Occupational Vision Optometrist
OPT 15011 TLG
CA
Other
Enumeration date
11/03/2014
Last updated
02/13/2020
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