SPINE SPORTS SURGERY CENTER, LLC (NPI# 1679913552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679913552 |
| Entity Type | Organization |
| Organization Name | SPINE SPORTS SURGERY CENTER, LLC |
| Other Organization Name | SPINE AND SPORTS SURGERY CENTER |
| Practice Address |
429 Llewellyn Ave Campbell CA 95008-1948 |
| Practice Telephone | 4083641616 |
| Practice Fax Number | 4085204295 |
| Mailing Telephone | 4083641616 |
| Mailing Fax Number | 4085204295 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2015-03-12 |
| Authorized Official Name | DR. SHERMAN N TRAN (OWNER) |
| Authorized Official Telephone | 4083641616 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN | F1851 | 01 |
| Other Name | Type Code |
|---|---|
| Spine and Sports Surgery Center | Doing Business As Name - Organization |
| Street Address |
429 LLEWELLYN AVE |
| City | CAMPBELL |
| State | CA |
| Zip Code | 95008-1948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457345944 | Felicia Radu-radulescu | Specialist | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2005-09-12 |
| 1053879395 | Bay Area Pain Rehab Professional Corporation | Clinic/Center | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2019-03-05 |
| 1659860302 | Jothi Murali Md Inc | Orthopaedic Surgery | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2018-05-08 |
| 1659632339 | Mikiko Murakami | Physical Medicine & Rehabilitation | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2012-05-30 |
| 1841551579 | Nicholas Colyvas Md Inc | Orthopaedic Surgery | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2012-05-29 |
| 1043576978 | James Pascua | Radiologic Technologist | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2012-04-04 |
| 1982909677 | Rebecca Carroll | Radiologic Technologist | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2011-01-11 |
| 1992013148 | Michael Komar | Radiologic Technologist | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2010-09-22 |
| 1699083303 | Titus Hodge | Radiologic Technologist | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2010-09-15 |
| 1710114772 | Abhishek Gowda | Physical Medicine & Rehabilitation | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2009-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298380 | Kerry Lynn Osteen | Massage Therapist | 3579 S Bascom Ave, Apt 5, Campbell, CA 95008 | 2020-09-02 |
| 1164057550 | Francesca Dalangin | Physical Therapist | 163 E. Hamilton Avenue, Campbell, CA 95008 | 2020-03-06 |
| 1144790767 | Haley Brucato | Behavior Technician | 131 Rose Court Apt. 21, Campbell, CA 95008 | 2018-11-27 |
| 1740765809 | Crystal-xuanthao Nguyen Curammeng | Licensed Vocational Nurse | 251 Llwelyn Ave, Campbell, CA 95008 | 2018-09-25 |
| 1841799236 | Gabrielle Suzanne Buma | Physician Assistant | Uplift Family Services 251 Llewellyn Ave, Campbell, CA 95008 | 2018-02-12 |
| 1093214660 | Toni Lynn Clementi | Marriage & Family Therapist | 116 E. Campbell Ave, Campbell, CA 95008 | 2018-02-08 |
| 1184132573 | My Hanh Thi Nguyen | Behavioral Analyst | 1440 Theresa Avenue, Campbell, CA 95008 | 2018-01-19 |
| 1346770948 | Stephanie Michele Klahold | Pharmacist | 100 North San Tomas Aquino Road, Campbell, CA 95008 | 2017-06-15 |
| 1578095378 | Elina Josephson | Marriage & Family Therapist | 155 E Campbell Ave Ste 117, Campbell, CA 95008 | 2017-03-30 |
| 1912448408 | Suzane Mitchualmacauley | Licensed Vocational Nurse | 251 Llewelyn Ave, Uplift Family Services, Campbell, CA 95008 | 2017-03-16 |
| Find all providers in zip 95008 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598282196 | Aesthetx Surgery Center, A Medical Corporation | Clinic/Center | 3803 S Bascom Ave Ste 101, Campbell, CA 95008-7317 | 2017-08-24 |
| 1659820702 | Campbell Surgery Center | Clinic/Center | 3425 S Bascom Ave Ste 100, Campbell, CA 95008-7300 | 2016-09-30 |
| 1174591143 | Silicon Valley Surgery Center, Lp | Clinic/Center | 3803 S Bascom Ave Ste 106, Campbell, CA 95008-7317 | 2006-03-08 |
| 1063712743 | Medical Arts Surgery Suite A Medical Corporation | Clinic/Center | 3803 S Bascom Ave, Suite 100, Campbell, CA 95008-7317 | 2010-10-27 |
| 1053440917 | Los Gatos Spinal Diagnostic, Inc | Clinic/Center | 429 Llewellyn Ave, Campbell, CA 95008-1948 | 2007-03-05 |
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| 1366041469 | The Regents of The University of California | Clinic/Center | 4343 Lankershim Blvd Ste 210, North Hollywood, CA 91602-2705 | 2020-10-20 |
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1538775267 | Ev Surgery Institute LLC | Clinic/Center | 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 | 2020-09-18 |
| 1003420001 | On Beach Surgery Center, LLC | Clinic/Center | 5832 Beach Blvd, Suite 210, Buena Park, CA 90621 | 2020-09-07 |
| 1811501661 | Precision Surgical Arts | Clinic/Center | 20311 Sw Birch St Ste 201, Newport Beach, CA 92660-1777 | 2020-08-31 |
| 1205448750 | Elite Surgery Center of South Bay LLC | Clinic/Center | 20528 Hawthorne Blvd Ste 301, Torrance, CA 90503-3202 | 2020-08-17 |
| 1740891571 | Peninsula Surgery Center, LLC | Clinic/Center | 350 Marine Pkwy Ste 100, Redwood City, CA 94065-5224 | 2020-08-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.