# SOUTH COAST FITTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699043596
- **Authorized official:** STACIE BETH GREENSPAN (PARTNER)
- **Authorized official phone:** (323) 605-4101

## Contact information

- **Practice address:** 3334 E COAST HWY, SUITE 278, CORONA DEL MAR, CA 92625-2328
- **Practice address phone:** (323) 605-4101
- **Practice address fax:** (702) 476-0720
- **Mailing address:** 3334 E COAST HWY, SUITE 278, CORONA DEL MAR, CA 92625-2328
- **Mailing address phone:** (323) 605-4101
- **Mailing address fax:** (702) 476-0720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 55970 | CA | Yes |

## Other

- **Enumeration date:** 12/06/2011
- **Last updated:** 12/06/2011