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JILL MARIE WAALEN MD
NPI 1578611554
General Practice in San Diego, CA

Active since January 08, 2007
4405 VANDEVER AVE, SAN DIEGO, CA 92120(619) 528-5000 Get Directions Write a Review

NPPES record last updated: November 30, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jill Marie Waalen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JILL MARIE WAALEN MD (NPI 1578611554) is an individual general practice provider in San Diego, California, licensed in California (A69683) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1578611554
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameJILL MARIE WAALENCredential: MD
Location Address4405 VANDEVER AVESan Diego, CA 92120-3315
Mailing Address393 E Walnut St, 3rd Floor Phr SystemsPasadena, CA 91188-0001 · (000) 000-0000 · Fax (000) 000-0000
Phone(619) 528-5000
Sole ProprietorNo
Enumeration DateJanuary 8, 2007
Last NPPES UpdateNovember 30, 2007
✔ NPI 1578611554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · A69683
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
4405 VANDEVER AVE, San Diego, CA 92120
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Other Identifiers 2

Medicare UPINI50779
Medicaid00A696830CA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADELINE C SERAFINE CNM
Advanced Practice Midwife
4405 VANDEVER AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
MICHAEL L. BONIN MD
Pathology (Blood Banking & Transfusion Medicine)
4405 VANDEVER AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
HEIDEMARIE DREGER CRNA
Nurse Anesthetist, Certified Registered
4405 VANDEVER AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
GILBERT B. GREEN MD
Psychiatry & Neurology (Psychiatry)
4405 VANDEVER AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
THOMAS LOHNER MD
Pediatrics
4405 VANDEVER AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
DR. PHILIP HYUNWOO KIM M.D.
Urology
4405 VANDEVER AVE, UROLOGIC SURGERY
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
JOANNE HAY-LING WONG M.D.
Pediatrics
4405 VANDEVER AVE
SAN DIEGO, CA 92120
San Diego County (833) 574-2273
JAMES MICHAEL KELLY MD
Family Medicine
4405 VANDEVER AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jill Waalen's NPI number?

The NPI number for Jill Waalen is 1578611554. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Where is Jill Waalen located?

Jill Waalen practices at 4405 Vandever Ave, San Diego, CA 92120. The listed phone number is (619) 528-5000.

What is Jill Waalen's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Jill Waalen was last updated on November 30, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.