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1699807792
JACQUELYN LEE VANDER WALL
IRVINE, CA
NPI
1699807792
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207RG0300X Internal Medicine, Geriatric Medicine
(Licence: CA G065045)
Enumeration Date
2007-03-12
Last Update Date
2017-09-13
Business Address
-- JACQUELYN LEE VANDER WALL M.D.
11 TECHNOLOGY DR
IRVINE, CA 92618-2302
Phone number: 949-923-3250
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Mailing Address
-- JACQUELYN LEE VANDER WALL M.D.
3460 KATELLA AVE
LOS ALAMITOS, CA 90720-2334
Phone number: 562-594-6599
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