Individual provider Active NPI

Leor Matalon, M.D

  • Psychiatry Physician
  • Vista, CA
National Provider Identifier
1114952876
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A62950 Issued in CA
Practice address
440 S Melrose Dr Ste 201
Vista, CA 92081-6666
Phone
(760) 452-5150
Fax
(858) 764-2820
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A62950 CA Primary

Addresses

Primary practice location

440 S Melrose Dr Ste 201
Vista, CA 92081-6666

Mailing address

8070 La Jolla Shores Dr
265
La Jolla, CA 92037-3230
Phone (760) 826-2120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A62950CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Litos O. Mallare, M.D., Inc. Psychiatry Past Accepting new patients
Behavioral Health Medical Group of Beverly Hills Inc. Psychiatry Past Accepting new patients
Pacific Health Systems, L.P. Psychiatry PastSince Oct 1, 2005 Accepting new patients
Advanced TMS Clinic Inc Psychiatry PastSince May 24, 2020 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1114952876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8070 LA JOLLA SHORES DR",
            "address_2": "265",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920373230",
            "telephone_number": "760-826-2120",
            "fax_number": "858-764-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 S MELROSE DR STE 201",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816666",
            "telephone_number": "760-452-5150",
            "fax_number": "858-764-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATALON",
        "first_name": "LEOR",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A62950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.