MEDICARE: RIVERSIDE ONCOLOGY PC

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	2085R0001X	Radiation Oncology Physician

General Provider Information

NPI Number	:	1285519256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERSIDE ONCOLOGY PC

Provider Business Mailing Address
First Line	:	9139 W THUNDERBIRD RD STE 220
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85381-4924
Country	:	US
Telephone Number	:	602-932-8288
Fax Number	:	602-932-8288

Provider Business Practice Location Address
First Line	:	6939 PALM CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-2815
Country	:	US
Telephone Number	:	858-603-0172
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	DR. KEVIN EUGENE SANDERS
Credential	:	MD
Telephone Number	:	253-330-0353

Provider Enumeration Date	:	08/08/2025
Last Update Date	:	08/08/2025

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