Individual provider Active NPI

Matthew Long, MD

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1376172932
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A204278 Issued in CA
Practice address
38400 Bob Wilson Dr
San Diego, CA 92134-5000
Phone
(802) 338-5164
NPI assigned
Apr 6, 2020
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A204278 CA Primary
Military Health Care Provider 171000000X A204278 CA

Addresses

Primary practice location

38400 Bob Wilson Dr
San Diego, CA 92134-5000

Mailing address

200 Mercy Cir
Camp Pendleton, CA 92055-5191

Other practice location 1

Area 13
Building 13127
Camp Pendleton, CA 92055-5191
Phone (760) 763-0306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260223003393 CA Practitioner - Psychiatry 0042791543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1080 Marina Village Pkwy
Suite 100
Alameda, CA 94501-1011

1080 Marina Village Pkwy
Suite 100
Alameda, CA 94501-1078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A204278CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Jan 6, 2026 Accepting new patients
Telecare Corporation CurrentSince Jan 6, 2026 Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

3211 Jefferson St
San Diego, CA 92110
Phone (619) 682-4012

3491 Kurtz St
Ste 150
San Diego, CA 92110
Phone (619) 276-1176

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1376172932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIR",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38400 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000",
            "telephone_number": "802-338-5164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Area 13",
            "address_2": "Building 13127",
            "address_purpose": "LOCATION",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "country_code": "US",
            "telephone_number": "760-763-0306",
            "fax_number": "802-683-3698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A204278",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "CA",
            "license": "A204278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.