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)CodeLicenseStatePrimary
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 Doing business as

Other providers in San Diego, CA

All providers in San Diego, CA · Medical Specialty Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.