Jacquelyn V Vander Wall (NPI# 1699807792, PAC ID# 6002871506) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1699807792 |
| PAC ID by PECOS | 6002871506 |
| Professional Enrollment ID | I20041123001272 |
| Full Name | Jacquelyn V Vander Wall |
| Organization Legal Name | CENTERS FOR FAMILY MEDICINE |
| Address |
3460 Katella Ave Los Alamitos CA 90720-2334 |
| Phone Number | 5625946599 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 9931143799 |
| Number of Group Practice Members | 122 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050485 | LONG BEACH MEMORIAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3460 Katella Ave, Los Alamitos, CA 90720-2334 | 5625946599 | CENTERS FOR FAMILY MEDICINE |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_046_65+ | Medication Reconciliation Post-Discharge | 100% | |
| MIPS_EC_046_65+ | Medication Reconciliation Post-Discharge | 100% | |
| MIPS_EC_046_overall | Medication Reconciliation Post-Discharge | 100% | |
| MIPS_EC_046_overall | Medication Reconciliation Post-Discharge | 100% |
| Organization Legal Name | CENTERS FOR FAMILY MEDICINE |
| Physicians | 137 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Rae Park | Family Medicine | Centers for Family Medicine | 10601 Walker St, Suite 250, Cypress, CA 90630-4733 |
| Au-co Ly Nguyen | Family Medicine | Centers for Family Medicine | 13930 Seal Beach Blvd, Seal Beach, CA 90740-5301 |
| Faranak Chloe Ghazi | Family Medicine | Centers for Family Medicine | 29873 Santa Margarita Pkwy, Suite 100, Rancho Santa Margarita, CA 92688-3626 |
| Bassam R Bilal | Internal Medicine | Centers for Family Medicine | 30281 Golden Lantern, Laguna Niguel, CA 92677-5979 |
| Dora Akuetteh Saforo | Family Medicine | Centers for Family Medicine | 145 Thunder Dr, Vista, CA 92083-6010 |
| Shahnoos Mahdavi | Internal Medicine | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Gary Paul Korff | Family Medicine | Centers for Family Medicine | 2562 State St D, Carlsbad, CA 92008-1663 |
| Lothar Mcmillian | Family Medicine | Centers for Family Medicine | 724 S El Camino Real, San Clemente, CA 92672-4250 |
| Lizander C Pandy | Family Medicine | Centers for Family Medicine | 32312 Camino Capistrano, San Juan Capistrano, CA 92675-4518 |
| Elmo M Agatep | Family Medicine | Centers for Family Medicine | 1198 Pacific Coast Hwy, Suite I, Seal Beach, CA 90740-6248 |
| Street Address |
3460 KATELLA AVE |
| City | LOS ALAMITOS |
| State | CA |
| Zip | 90720-2334 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shahnoos Mahdavi | Internal Medicine | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Ellen Dayon | Internal Medicine | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Paul D Sychangco | Internal Medicine | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Deborah L Pauer | Family Medicine | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Stuart C Seigel | Endocrinology | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Nima Taheri | Hospitalist | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Tung H Ngo | Internal Medicine | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Ourania Z Papantoniadis | Physician Assistant | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Strettapon Suriyaniel | Internal Medicine | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Kambiz V Karimi | Internal Medicine | Centers for Family Medicine | 3460 Katella Ave, Los Alamitos, CA 90720-2334 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Haniffa M Maznavi | Internal Medicine | 3791 Katella Ave, Suite 101, Los Alamitos, CA 90720-2000 | |
| Sharon Kelly | Psychologist, Clinical | 3791 Katella Ave, Suite 106, Los Alamitos, CA 90720-2000 | |
| Lawrence G Waldrop | Internal Medicine | 3791 Katella Ave, Suite 104, Los Alamitos, CA 90720-2000 | |
| Mauricio J Heilbron Jr. | General Surgery | Prohealth Partners, A Medical Group | 3791 Katella Ave, Suite 107, Los Alamitos, CA 90720-2000 |
| Harold M Lin | Internal Medicine | 3791 Katella Ave, Suite 105, Los Alamitos, CA 90720-2000 | |
| Mark M Chung | Pulmonary Disease | 3791 Katella Ave, Suite 103, Los Alamitos, CA 90720-2000 | |
| Steve C Landis | Chiropractic | 3621 Farquhar Ave, Los Alamitos, CA 90720-2005 | |
| Craig F Hite | Chiropractic | 3621 Farquhar Ave, Los Alamitos, CA 90720-2005 | |
| David L Vannix | General Surgery | Vascular and General Surgery Associates | 3791 Katella Ave, Suite 201, Los Alamitos, CA 90720-2016 |
| Fritz Baumgartner | Thoracic Surgery | Vascular and General Surgery Associates | 3791 Katella Ave, Suite 201, Los Alamitos, CA 90720-2016 |
| Find all physicians in zip 90720 | |||
| City | LOS ALAMITOS |
| Zip Code | 90720 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | LOS ALAMITOS + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Jacquelyn V Vander Wall.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.