NPIMap

Organization Active NPI

Cerebral Medical Group, a Professional Corporation

  • Psychiatry Physician
  • Glendale, CA
National Provider Identifier
1992355879
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CEREBRAL MEDICAL GROUP, A PROFESSIONAL CORPORATION
Practice address
330 N Brand Blvd
Glendale, CA 91203-2308
Phone
(628) 263-3658
Fax
(628) 263-3658
NPI assigned
Sep 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Michael Nathan Boggs, MD
Title
President
Phone
(802) 989-4546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

330 N Brand Blvd
Glendale, CA 91203-2308

Mailing address

2093 Philadelphia Pike # 9898
Claymont, DE 19703-2424
Phone (628) 263-3658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210303000840 TX Part B Supplier - Clinic/Group Practice 6709206238 Receives reassigned benefits from 30 practitioners
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations (25 of 49)

333 Business Cir
Pelham, AL 35124
Phone (205) 255-3828

10025 W Markham St
Little Rock, AR 72205

2 E Congress St
Ste 900
Tucson, AZ 85701
Phone (520) 618-4100

2 E Congress St
Ste 900126
Tucson, AZ 85701

2 E Congress St
Tucson, AZ 85701

555 W 5th St
Los Angeles, CA 90013
Phone (954) 804-9724

555 W 5th St
Fl 35
Los Angeles, CA 90013
Phone (415) 510-2671

Virtual Visits Only Address
Sacramento, CA 94209

995 Market St
San Francisco, CA 94103
Phone (415) 348-1814

340 S Lemon Ave
Ste 9892
Walnut, CA 91789
Phone (415) 617-9894

340 S Lemon Ave
#9892
Walnut, CA 91789

340 S Lemon Ave
Ste 1295
Walnut, CA 91789
Phone (877) 241-8200

340 S Lemon Ave
Unit 9892
Walnut, CA 91789
Phone (415) 651-3458

501 E Kennedy Blvd
Tampa, FL 33602
Phone (561) 235-7613

501 E Kennedy Blvd
Ofc 16138
Tampa, FL 33602
Phone (415) 651-3458

1175 Peachtree St NE
Ste O9146
Atlanta, GA 30361

100 Windmont Dr NE
Brookhaven, GA 30329

309 Court Ave
Ste 813
Des Moines, IA 50309

332 S Michigan Ave
Ofc 8103
Chicago, IL 60604
Phone (815) 721-1223

112 SW 7th St
Ste C
Topeka, KS 66603

210 Saint Charles Ave
New Orleans, LA 70130

210 Saint Charles Ave
Ste 2500
New Orleans, LA 70130
Phone (504) 906-5134

1 Beacon St
Fl 15
Boston, MA 02108

415 Congress St
Portland, ME 04101
Phone (207) 881-6288

6001 Cass Ave
Ofc 3105
Detroit, MI 48202

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1992355879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 PHILADELPHIA PIKE # 9898",
            "city": "CLAYMONT",
            "state": "DE",
            "postal_code": "197032424",
            "telephone_number": "628-263-3658",
            "fax_number": "628-263-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N BRAND BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032308",
            "telephone_number": "628-263-3658",
            "fax_number": "628-263-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREBRAL MEDICAL GROUP, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-989-4546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.