Healthcare Provider Details

I. General information

NPI: 1518908847
Provider Name (Legal Business Name): NEWPORT COAST RADIATION ONCOLOGY MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE HOAG DRIVE CANCER CENTER
NEWPORT BEACH CA
92663-4162
US

IV. Provider business mailing address

PO BOX 8598
PASADENA CA
91109-8605
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-5528
  • Fax: 949-764-8106
Mailing address:
  • Phone: 949-263-8620
  • Fax: 949-263-0473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG53677
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberG28037
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA70756
License Number StateCA

VIII. Authorized Official

Name: CRAIG COX JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 615-296-0952