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Organization

PRESIDIUM MEDICAL GROUP PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ASHKAN HAYATDAVOUDI MD (OWNER)
(619) 738-5566
Entity
Organization

Contact information

Practice address
32 E EXCHANGE PL FL 6, SALT LAKE CITY, UT 84111-2704
(619) 738-5566
Mailing address
32 E EXCHANGE PL FL 6, SALT LAKE CITY, UT 84111-2704
(619) 738-5566
(619) 566-0202

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary

Other

Enumeration date
04/22/2025
Last updated
04/22/2025
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