MEDICARE: DR. CHRISTY L WALTER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	20A9231	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801859160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTY L WALTER DO

Provider Business Mailing Address
First Line	:	PO BOX 11179
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92685-1179
Country	:	US
Telephone Number	:	888-517-2788
Fax Number	:	562-468-0347

Provider Business Practice Location Address
First Line	:	951 N WASHINGTON AVE
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32796-2163
Country	:	US
Telephone Number	:	321-268-6111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	09/30/2025

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