Provider Demographics
NPI:1548916745
Name:ADVANCE TEXTILES OF CALIFORNIA, LLC
Entity type:Organization
Organization Name:ADVANCE TEXTILES OF CALIFORNIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-365-2602
Mailing Address - Street 1:639 BAIR ISLAND RD STE 104
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2753
Mailing Address - Country:US
Mailing Address - Phone:650-365-2602
Mailing Address - Fax:
Practice Address - Street 1:639 BAIR ISLAND RD STE 104
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2753
Practice Address - Country:US
Practice Address - Phone:650-365-2602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty