Provider Demographics
NPI:1023422730
Name:WATCHA, DAENA SARAH (MD, MS)
Entity type:Individual
Prefix:DR
First Name:DAENA
Middle Name:SARAH
Last Name:WATCHA
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21010 ANZA AVE
Mailing Address - Street 2:APT 27
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4213
Mailing Address - Country:US
Mailing Address - Phone:650-387-4000
Mailing Address - Fax:310-782-1763
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502
Practice Address - Country:US
Practice Address - Phone:310-222-3501
Practice Address - Fax:310-782-1763
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA140302207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine