Healthcare Provider Details

I. General information

NPI: 1386609725
Provider Name (Legal Business Name): VENTURA COUNTY RADIATION ONCOLOGY MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 12/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N ROSE AVE SUITE 120
OXNARD CA
93030-3790
US

IV. Provider business mailing address

1700 N ROSE AVE SUITE 120
OXNARD CA
93030-3790
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-2657
  • Fax: 805-981-4456
Mailing address:
  • Phone: 805-988-2657
  • Fax: 805-981-4456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG58104
License Number StateCA

VIII. Authorized Official

Name: DR. TIMOTHY A. OCONNOR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-988-2657