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General NPI Number Information
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NPI Number | 1699586388
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Entity Type | Organization
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Legal Business Name | MOELLER-BERTRAM MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 03/02/2025
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Provider Practice Location Address
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Address Line | 36101 BOB HOPE DR STE A1
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-2002
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Country | US
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Telephone | 760-321-1315
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Fax |
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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 |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. 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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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