Organization
COUNTY OF LOS ANGELES DMH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN SOUTHER DSW (DIRECTOR OF DMH)
(213) 738-4651
Entity
Organization
Contact information
Practice address
921 E COMPTON BLVD, COMPTON, CA 90221-3303
(310) 668-6855
Mailing address
1401 W MAGNOLIA ST, COMPTON, CA 90220-1501
(310) 594-1332
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
LCS21312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
CA
Enumeration date
03/08/2007
Last updated
08/22/2020
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