Provider Demographics
NPI:1417037680
Name:LEE, GILBERT WESLEY (MD FACS)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:WESLEY
Last Name:LEE
Suffix:
Gender:M
Credentials:MD FACS
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Mailing Address - Street 1:11515 EL CAMINO REAL
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130
Mailing Address - Country:US
Mailing Address - Phone:858-720-1440
Mailing Address - Fax:858-509-7738
Practice Address - Street 1:11515 EL CAMINO REAL
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130
Practice Address - Country:US
Practice Address - Phone:858-720-1440
Practice Address - Fax:858-509-7738
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2016-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG639072086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F65386Medicare UPIN
F65386Medicare UPIN