Provider Demographics
NPI:1033163621
Name:RENEWED HOPE RADIATION ONCOLOGY, INC.
Entity Type:Organization
Organization Name:RENEWED HOPE RADIATION ONCOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-485-2824
Mailing Address - Street 1:1901 HOLSER WALK
Mailing Address - Street 2:SUITE 305
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2633
Mailing Address - Country:US
Mailing Address - Phone:805-485-2824
Mailing Address - Fax:805-485-4655
Practice Address - Street 1:1901 HOLSER WALK
Practice Address - Street 2:SUITE 305
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2633
Practice Address - Country:US
Practice Address - Phone:805-485-2824
Practice Address - Fax:805-485-4655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46608174400000X
261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A466080Medicaid
CAG04284Medicare UPIN
CAA46608Medicare ID - Type Unspecified