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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
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician

Other

Enumeration date
11/10/2016
Last updated
11/10/2016
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