# CALIFORNIA INSTITUTE OF PLASTIC AND RECONSTRUCTIVE SURGERY A MED. CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Changes Plastic Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609052893
- **Authorized official:** GILBERT WESLEY LEE M.D. (PHYSICIAN / OWNER)
- **Authorized official phone:** (858) 720-1440

## Contact information

- **Practice address:** 11515 EL CAMINO REAL STE 150, SAN DIEGO, CA 92130-3037
- **Practice address phone:** (858) 720-1440
- **Practice address fax:** (858) 509-7738
- **Mailing address:** 11515 EL CAMINO REAL STE 150, SAN DIEGO, CA 92130-3037
- **Mailing address phone:** (858) 720-1440
- **Mailing address fax:** (858) 509-7738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | G63907 | CA | Yes |

## Other

- **Enumeration date:** 01/17/2008
- **Last updated:** 07/07/2016