Jeanne Marie Wallace, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G30673 Issued in CA

Practice address

14445 Olive View Dr
Olive View UCLA Medical Center
Sylmar, CA 91342

Phone

(818) 364-4424

Fax

(818) 364-4428

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902831381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "address_2": "OLIVE VIEW UCLA MEDICAL CENTER",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-364-4424",
            "fax_number": "818-364-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "address_2": "OLIVE VIEW UCLA MEDICAL CENTER",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-364-4424",
            "fax_number": "818-364-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G30673",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G30673",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nguyen Vu, DDS
• Victor Nguyen-Huy Vu, MD
• Robin Yvonne Wachsner, MD
• Soma Wali
• Janice Denise Walker
• Michelle Wan, MD
• Anne Wang, PHARMACIST
• Daniel Wang, MD
• Stephanie Yue Wang, M.D.
• Anita Washington-Murphy, PHRAM.D.

• Internal Medicine Physician in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.