Healthcare Provider Details

I. General information

NPI: 1689938979
Provider Name (Legal Business Name): CHRISTOPHER PRESTEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 N MARIO CAPECCHI DR
SALT LAKE CITY UT
84113-1125
US

IV. Provider business mailing address

30 S MARIO CAPECCHI DR
SALT LAKE CITY UT
84112-5888
US

V. Phone/Fax

Practice location:
  • Phone: 801-442-5271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL34998
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number14270697-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: