Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Peter Soo-Hwan Kim

Individual provider Physician Assistant · NPI 1629688775

Peter Soo-Hwan Kim is a Physician Assistant in Chandler, Arizona. Qualified in 2020, 6 years ago. Practices with Banner Physician Specialists Arizona LLC, a 372-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
6
Licensed in
AZ
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

485 S Dobson Rd Ste 110
Chandler, AZ 85224-5600
Phone: (480) 728-4470
Fax: (480) 728-4499
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3420 S Mercy Rd Ste 200, Gilbert, AZ 85297-0423 — (480) 909-3788

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 8841 (AZ)

Record details

NPI number1629688775
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 4, 2020
Last updated in NPPESMay 26, 2026
Certification dateMay 26, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Banner Physician Specialists Arizona Llc — 372 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Chandler