Basic Information
Provider Information
NPI: 1689744872
EntityType: 2
ReplacementNPI:  
OrganizationName: BRINCETON M PHIPPS MD INCORPORATED
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 2 UNION ST
Address2:  
City: LADERA RANCH
State: CA
PostalCode: 926940418
CountryCode: US
TelephoneNumber: 9494295943
FaxNumber: 9494295943
Practice Location
Address1: 26730 CROWN VALLEY PKWY
Address2: SUITE 200
City: MISSION VIEJO
State: CA
PostalCode: 926916364
CountryCode: US
TelephoneNumber: 9493642154
FaxNumber: 9493642110
Other Information
ProviderEnumerationDate: 11/08/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: PHIPPS
AuthorizedOfficialFirstName: BRINCETON
AuthorizedOfficialMiddleName: MICHAEL
AuthorizedOfficialTitleorPosition: ORTHOPAEDIC SURGEON
AuthorizedOfficialTelephone: 9493642154
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M. D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000XA80064CAY193400000X SINGLE SPECIALTY GROUPOther Service ProvidersSpecialist 

No ID Information.


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