Healthcare Provider Details

I. General information

NPI: 1184504318
Provider Name (Legal Business Name): MISSION OSTEOPATHY MEDICAL CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SEAPORT CT STE 203
REDWOOD CITY CA
94063-2767
US

IV. Provider business mailing address

2731 SUMMIT DR
HILLSBOROUGH CA
94010-6039
US

V. Phone/Fax

Practice location:
  • Phone: 650-640-2430
  • Fax:
Mailing address:
  • Phone: 650-640-2430
  • Fax: 650-897-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KELLEY BRINSKY
Title or Position: OWNER
Credential: DO
Phone: 650-640-2430