Provider Demographics
NPI:1225228026
Name:CHOI, PETER SANGBEOM (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:SANGBEOM
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16635 N 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-2707
Mailing Address - Country:US
Mailing Address - Phone:602-843-7900
Mailing Address - Fax:602-843-7903
Practice Address - Street 1:16635 N 43RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-2707
Practice Address - Country:US
Practice Address - Phone:602-843-7900
Practice Address - Fax:602-843-7903
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine