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General NPI Number Information
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NPI Number | 1366339673
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Entity Type | Organization
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Legal Business Name | TOBIAS MOELLER-BERTRAM MD CORPORATION
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 1695 S SAN JACINTO AVE STE A, C & D
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City | SAN JACINTO
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State | CA
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Zip | 92583-5103
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Country | US
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Telephone | 951-330-3100
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Fax | 951-350-1050
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Provider Business Mailing Address
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Address Line | 44630 MONTEREY AVE STE 100
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City | PALM DESERT
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State | CA
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Zip | 92260-3326
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Country | US
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Telephone | 800-285-3755
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TOBIAS MOELLER-BERTRAM
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Credential | MD
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Telephone | 800-285-3755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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