Healthcare Provider Details

I. General information

NPI: 1306700869
Provider Name (Legal Business Name): TURNOUT MEDICAL GROUP WEST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 S 1ST ST STE 200
SAN JOSE CA
95113-2835
US

IV. Provider business mailing address

2683 VIA DE LA VALLE STE G505
DEL MAR CA
92014-1911
US

V. Phone/Fax

Practice location:
  • Phone: 800-499-8876
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: ITAI HIRSCH
Title or Position: OPERATIONS ADMIN
Credential:
Phone: 800-499-8876