Organization
COUNTY OF LOS ANGELES DMH
Active
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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