Healthcare Provider Details

I. General information

NPI: 1174488704
Provider Name (Legal Business Name): FORESIGHT HEALTH MEDICAL WEST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
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

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

V. Phone/Fax

Practice location:
  • Phone: 510-880-3084
  • Fax:
Mailing address:
  • Phone: 510-880-3084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIN JACQUELINE CHANG
Title or Position: OPERATIONS ADMINISTRATOR
Credential:
Phone: 510-880-3084