Active NPI
Gilbert Wesley Lee, MD FACS
- Plastic and Reconstructive Surgery Physician
- San Diego, CA
National Provider Identifier
1417037680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- G63907
- Practice address
- 11515 El Camino Real
Suite 150
San Diego, CA 92130 - Phone
- (858) 720-1440
- Fax
- (858) 509-7738
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | G63907 | CA | Primary |
Addresses
Primary practice location
11515 El Camino Real
Suite 150
San Diego, CA 92130
Mailing address
11515 El Camino Real
Suite 150
San Diego, CA 92130
Phone (858) 720-1440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63907 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1417037680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11515 EL CAMINO REAL",
"address_2": "SUITE 150",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92130",
"telephone_number": "858-720-1440",
"fax_number": "858-509-7738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11515 EL CAMINO REAL",
"address_2": "SUITE 150",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92130",
"telephone_number": "858-720-1440",
"fax_number": "858-509-7738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "GILBERT",
"middle_name": "WESLEY",
"name_prefix": "Dr.",
"credential": "MD FACS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "CA",
"license": "G63907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.