Provider Demographics
NPI:1144300385
Name:PHIPPS, GARY JACK (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:JACK
Last Name:PHIPPS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:26720 CROWN VALLEY PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-364-2154
Mailing Address - Fax:949-364-2110
Practice Address - Street 1:26720 CROWN VALLEY PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-364-2154
Practice Address - Fax:949-364-2110
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2008-10-02
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Provider Licenses
StateLicense IDTaxonomies
CA000000C42990207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma