MEDICARE: TEIKO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KI0005X	Clinical & Laboratory Immunology (Allergy & Immunology) Physician

General Provider Information

NPI Number	:	1790612091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEIKO

Provider Business Mailing Address
First Line	:	675 S ARAPEEN DR STE 301
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 S ARAPEEN DR STE 301
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1205
Country	:	US
Telephone Number	:	385-355-9108
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RAMJI SRINIVASAN
Credential	:
Telephone Number	:	650-714-1635

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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Directions to “TEIKO ” Practice Location

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