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CALIFORNIA INSTITUTE OF PLASTIC AND RECONSTRUCTIVE SURGERY A MED. CORP NPI 1609052893


NPI Information

NPI: 1609052893
Provider Name: CALIFORNIA INSTITUTE OF PLASTIC AND RECONSTRUCTIVE SURGERY A MED. CORP

Doing Business As: CHANGES PLASTIC SURGERY

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
11515 EL CAMINO REAL STE 150
SAN DIEGO, CA
ZIP 92130
Phone: (858) 720-1440
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CALIFORNIA INSTITUTE OF PLASTIC AND RECONSTRUCTIVE SURGERY A MED. CORP is a medical specialty clinic center in San Diego, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). CALIFORNIA INSTITUTE OF PLASTIC AND RECONSTRUCTIVE SURGERY A MED. CORP NPI is 1609052893. The provider is registered as an organization entity type.
The provider Is Doing Business As Changes Plastic Surgery.

The provider's business location address is:

11515 EL CAMINO REAL STE 150
SAN DIEGO, CA
ZIP 92130-037
Phone: (858) 720-1440
Fax: (858) 509-7738

The provider's authorized official is Gilbert Wesley Lee .
The authorized official title is Physician / Owner and has the following contact phone number (858) 720-1440.

The enumeration date for this NPI number is 1/17/2008 and was last updated on 7/7/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyG63907CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W13535MEDICARE PINCALIFORNIA
2F65386MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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