California Institute of Plastic and Reconstructive Surgery a Med. Corp
Organization Active NPI Medical Specialty Clinic/Center · San Diego, CA
NPI 1609052893 · NPPES record last updated Jul 7, 2016
Key facts
- NPI
- 1609052893
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- License
- G63907 (CA)
- Legal business name
- CALIFORNIA INSTITUTE OF PLASTIC AND RECONSTRUCTIVE SURGERY A MED. CORP
- Practice address
- 11515 El Camino Real Ste 150
San Diego, CA 92130-3037 - Phone
- (858) 720-1440
- Fax
- (858) 509-7738
- NPI assigned
- Jan 17, 2008
- Organization subpart
- No
Authorized official
- Name
- Gilbert Wesley Lee, M.D.
- Title
- Physician / Owner
- Phone
- (858) 720-1440
National Provider Directory
Locations
11515 El Camino Real
Ste 150
San Diego, CA 92130
Phone (858) 720-1440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | G63907 | CA | Yes |
Addresses
Primary practice location
11515 El Camino Real Ste 150
San Diego, CA 92130-3037
Mailing address
11515 El Camino Real Ste 150
San Diego, CA 92130-3037
Phone (858) 720-1440
Other names
- Changes Plastic Surgery
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.