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General NPI Number Information
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NPI Number | 1184504318
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Entity Type | Organization
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Legal Business Name | MISSION OSTEOPATHY MEDICAL CLINIC, PC
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 400 SEAPORT CT STE 203
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City | REDWOOD CITY
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State | CA
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Zip | 94063-2767
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Country | US
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Telephone | 650-640-2430
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Fax |
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Provider Business Mailing Address
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Address Line | 2731 SUMMIT DR
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City | HILLSBOROUGH
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State | CA
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Zip | 94010-6039
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Country | US
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Telephone | 650-640-2430
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Fax | 650-897-5109
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Authorized Official
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Title or Position | OWNER
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Name | DR. KELLEY BRINSKY
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Credential | DO
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Telephone | 650-640-2430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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