Healthcare Provider Details

I. General information

NPI: 1760350466
Provider Name (Legal Business Name): CHRISTOS WALK IN DERMATOLOGY AND MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2025
Last Update Date: 10/25/2025
Certification Date: 10/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49400 RIVER PARK RD APT 52
OAKHURST CA
93644-9119
US

IV. Provider business mailing address

49400 RIVER PARK RD APT 52
OAKHURST CA
93644-9119
US

V. Phone/Fax

Practice location:
  • Phone: 954-682-9329
  • Fax:
Mailing address:
  • Phone: 954-682-9329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER SMITH
Title or Position: MGMR
Credential: DO
Phone: 954-682-9329