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Organization
UNDONO CARE ANAHEIM 1, LLC
Active
Organization
UNDONO CARE ANAHEIM 1, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMLIEN TRAN (MANAGER)
(858) 717-0088
Entity
Organization
Contact information
Practice address
1248 S MAGNOLIA AVE, ANAHEIM, CA 92804-5116
(714) 883-9541
(888) 568-3105
Mailing address
1248 S MAGNOLIA AVE, ANAHEIM, CA 92804-5116
(714) 883-9541
(888) 568-3105
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
11/10/2016
Last updated
11/10/2016
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