1. Home
  2. Directory
  3. Utah
  4. Salt Lake City
  5. Family Medicine
  6. NPI Profile

PRESIDIUM MEDICAL GROUP PLLC
NPI 1689461774
Family Medicine - Adult Medicine in Salt Lake City, UT

Active since April 22, 2025
32 E EXCHANGE PL FL 6, SALT LAKE CITY, UT 84111(619) 738-5566 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Presidium Medical Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRESIDIUM MEDICAL GROUP PLLC (NPI 1689461774) is a healthcare organization registered as an adult medicine in Salt Lake City, Utah and active in the NPI registry since April 2025. The organization lists Ashkan Hayatdavoudi, Owner, as its authorized official.

NPPES Registry Identity

NPI1689461774
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NamePRESIDIUM MEDICAL GROUP PLLC
Location Address32 E EXCHANGE PL FL 6Salt Lake City, UT 84111-2704
Mailing Address32 E Exchange Pl Fl 6Salt Lake City, UT 84111-2704 · (619) 738-5566 · Fax (619) 566-0202
Phone(619) 738-5566
Organization SubpartNo
Authorized OfficialAshkan HayatdavoudiOwner · (619) 738-5566
Enumeration DateApril 22, 2025
NPPES CertifiedApril 22, 2025
✔ NPI 1689461774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
32 E EXCHANGE PL FL 6, Salt Lake City, UT 84111
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Presidium Medical Group PLLC's NPI number?

The NPI number for Presidium Medical Group PLLC is 1689461774. It was assigned to this organization in the NPPES registry on April 22, 2025.

Where is Presidium Medical Group PLLC located?

Presidium Medical Group PLLC is located at 32 E Exchange Pl Fl 6, Salt Lake City, UT 84111. The listed phone number is (619) 738-5566.

What is Presidium Medical Group PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Presidium Medical Group PLLC was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.