Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacquelyn Vander Wall MD Inc

Organization Specialist · NPI 1386724375

Jacquelyn Vander Wall MD Inc is a Specialist in Irvine, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11 Technology Dr
Irvine, CA 92618-2302
Phone: (949) 923-3250
Fax: (855) 812-5865
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence G065045 (CA)

Record details

NPI number1386724375
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacquelyn Vander Wall — Md · (562) 594-6599
Other names Optumcare Medical Group
NPI enumeratedOctober 16, 2006
Last updated in NPPESApril 26, 2016
Mailing address3460 Katella Ave, Los Alamitos, CA 90720-2334

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