Healthcare Provider Details

I. General information

NPI: 1003846189
Provider Name (Legal Business Name): RALPH WATCHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N VERMONT AVE SUITE 901
LOS ANGELES CA
90027-6005
US

IV. Provider business mailing address

PO BOX 29160
LOS ANGELES CA
90029-0160
US

V. Phone/Fax

Practice location:
  • Phone: 323-912-9221
  • Fax: 323-912-9206
Mailing address:
  • Phone: 323-912-9221
  • Fax: 323-912-9206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA48327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: