MEDICARE: TOBIAS MOELLER-BERTRAM MD CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1790663391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOBIAS MOELLER-BERTRAM MD CORPORATION

Provider Business Mailing Address
First Line	:	18940 N PRIMA RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258
Country	:	US
Telephone Number	:	800-285-3755
Fax Number	:

Provider Business Practice Location Address
First Line	:	36101 BOB HOPE DR STE A
Second Line	:
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-2001
Country	:	US
Telephone Number	:	760-321-1315
Fax Number	:	760-321-1094

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL VON KOLEN
Credential	:
Telephone Number	:	800-285-3755

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	02/19/2026

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