Provider Demographics
NPI:1174206981
Name:ADVANCED TRANSIT SAN JOSE LLC
Entity type:Organization
Organization Name:ADVANCED TRANSIT SAN JOSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROMNICK
Authorized Official - Middle Name:
Authorized Official - Last Name:REGALARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-475-0239
Mailing Address - Street 1:320 SANSONI ST
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-8324
Mailing Address - Country:US
Mailing Address - Phone:408-475-0239
Mailing Address - Fax:
Practice Address - Street 1:320 SANSONI ST
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-8324
Practice Address - Country:US
Practice Address - Phone:408-475-0239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)