SPINE SPORTS SURGERY CENTER, LLC
NPI: 1679913552
· CAMPBELL, CA 95008
· Ambulatory Surgical Clinic/Center
· NPI assigned 06/25/2013
Deactivated NPI
· This NPI was deactivated on 07/17/2023. Reactivated 08/11/2023.
$88.05
Total Medicaid Paid
Provider Details
| Authorized Official | TRAN, SHERMAN (OWNER) |
| NPI Enumeration Date | 06/25/2013 |
Related Entities
Other providers sharing the same authorized official: TRAN, SHERMAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
12 |
$88.05 |
| 2024 |
22 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 72275 |
|
12 |
12 |
$88.05 |
| 64483 |
|
22 |
13 |
$0.00 |