Healthcare Provider Details
I. General information
NPI: 1033163621
Provider Name (Legal Business Name): RENEWED HOPE RADIATION ONCOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1901 HOLSER WALK SUITE 305
OXNARD CA
93036-2633
US
IV. Provider business mailing address
1901 HOLSER WALK SUITE 305
OXNARD CA
93036-2633
US
V. Phone/Fax
- Phone: 805-485-2824
- Fax: 805-485-4655
- Phone: 805-485-2824
- Fax: 805-485-4655
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | A46608 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QX0203X |
| Taxonomy | Radiation Oncology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADRIANA
SOSA
Title or Position: PRACTICE MANAGER
Credential:
Phone: 805-485-2824