| Peter Yun Soo Kim, MD | |
| 26357 Mcbean Pkwy, Valencia, CA 91355-4488 | |
| (661) 222-2620 | |
| (661) 222-2685 | 
| Full Name | Peter Yun Soo Kim | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics | 
| Location | 26357 Mcbean Pkwy, Valencia, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1467477638 | NPI | - | NPPES | 
| 00A488060 | Medicaid | CA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | A48806 (California) | Primary | 
| Entity Name | Providence Facey Medical Foundation | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1710031588 PECOS PAC ID: 3173436276 Enrollment ID: O20031105000822 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Peter Yun Soo Kim, MD Po Box 9602, Mission Hills, CA 91346-9602 Ph: (818) 837-5637 | Peter Yun Soo Kim, MD 26357 Mcbean Pkwy, Valencia, CA 91355-4488 Ph: (661) 222-2620 | 
| Dr. Michelle Grino Campana, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 23823 Valencia Blvd, Suite 120, Valencia, CA 91355 Phone: 661-253-4971 | |
| Rebecca Whitney Mandel, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 27867 Smyth Dr, Suite 100, Valencia, CA 91355 Phone: 661-294-2229 | |
| Mona Arvind Shah, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 23763 Valencia Blvd, Valencia, CA 91355 Phone: 661-287-1551 Fax: 661-255-8037 | |
| Dr. Sunanda Reddy Vadapalli, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 23823 Valencia Blvd, Suite 120, Valencia, CA 91355 Phone: 661-253-4971 Fax: 661-253-4972 | |
| Hasan Murad Chowdhury, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 26357 Mcbean Pkwy, Valencia, CA 91355 Phone: 661-222-2620 Fax: 661-222-2633 | |
| Hadar Levgur-fields, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 23763 Valencia Blvd, Valencia, CA 91355 Phone: 661-287-1551 Fax: 661-799-2952 | |
| Dr. Benjamin Harris Meisel, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 27506 Berkshire Hills Pl, Valencia, CA 91354 Phone: 661-284-5969 Fax: 661-284-5969 |