Provider Demographics
NPI:1871045476
Name:A & A ENTERPRISE GROUP LLC
Entity Type:Organization
Organization Name:A & A ENTERPRISE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:JONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-476-4198
Mailing Address - Street 1:4073 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3837
Mailing Address - Country:US
Mailing Address - Phone:408-476-4198
Mailing Address - Fax:
Practice Address - Street 1:4073 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-3837
Practice Address - Country:US
Practice Address - Phone:408-476-4198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A & A ENTERPRISE GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-30
Last Update Date:2016-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOC31973170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170300000XOther Service ProvidersGenetic Counselor, MSGroup - Single Specialty