# UNDONO CARE ANAHEIM 1, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639611445
- **Authorized official:** KIMLIEN TRAN (MANAGER)
- **Authorized official phone:** (858) 717-0088

## Contact information

- **Practice address:** 1248 S MAGNOLIA AVE, ANAHEIM, CA 92804-5116
- **Practice address phone:** (714) 883-9541
- **Practice address fax:** (888) 568-3105
- **Mailing address:** 1248 S MAGNOLIA AVE, ANAHEIM, CA 92804-5116
- **Mailing address phone:** (714) 883-9541
- **Mailing address fax:** (888) 568-3105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 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