Provider Demographics
NPI:1336036656
Name:TOBIAS MOELLER-BERTRAM MD CORPORATION
Entity type:Organization
Organization Name:TOBIAS MOELLER-BERTRAM MD CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TOBIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MOELLER-BERTRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-285-3755
Mailing Address - Street 1:44630 MONTEREY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3326
Mailing Address - Country:US
Mailing Address - Phone:800-285-3755
Mailing Address - Fax:
Practice Address - Street 1:81812 DOCTOR CARREON BLVD STE D
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5594
Practice Address - Country:US
Practice Address - Phone:760-647-7676
Practice Address - Fax:760-347-0909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOBIAS MOELLER-BERTRAM MD CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-19
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty