Healthcare Provider Details

I. General information

NPI: 1285519256
Provider Name (Legal Business Name): RIVERSIDE ONCOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6939 PALM CT
RIVERSIDE CA
92506-2815
US

IV. Provider business mailing address

9139 W THUNDERBIRD RD STE 220
PEORIA AZ
85381-4924
US

V. Phone/Fax

Practice location:
  • Phone: 858-603-0172
  • Fax:
Mailing address:
  • Phone: 602-932-8288
  • Fax: 602-932-8288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN EUGENE SANDERS
Title or Position: PROVIDER
Credential: MD
Phone: 253-330-0353