MEDICARE: RENEWED HOPE RADIATION ONCOLOGY, INC.

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	174400000X	Specialist	A46608	CA
2	261QX0203X	Radiation Oncology Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033163621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEWED HOPE RADIATION ONCOLOGY, INC.

Provider Business Mailing Address
First Line	:	1901 HOLSER WALK
Second Line	:	SUITE 305
City	:	OXNARD
State	:	CA
Zip	:	93036-2633
Country	:	US
Telephone Number	:	805-485-2824
Fax Number	:	805-485-4655

Provider Business Practice Location Address
First Line	:	1901 HOLSER WALK
Second Line	:	SUITE 305
City	:	OXNARD
State	:	CA
Zip	:	93036-2633
Country	:	US
Telephone Number	:	805-485-2824
Fax Number	:	805-485-4655

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	ADRIANA SOSA
Credential	:
Telephone Number	:	805-485-2824

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/16/2023

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