MEDICARE: GINA CARLOTTI MD

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	207Q00000X	Family Medicine Physician	54526	CT
2	207Q00000X	Family Medicine Physician	MD439263	PA
3	207Q00000X	Family Medicine Physician	141045	NC
4	207P00000X	Emergency Medicine Physician	141045	NC
5	207Q00000X	Family Medicine Physician	25MA08755800	NJ

General Provider Information

NPI Number	:	1306040373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA CARLOTTI MD

Provider Business Mailing Address
First Line	:	6255 W SUNSET BLVD FL 21
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7422
Country	:	US
Telephone Number	:	323-860-5200
Fax Number	:	323-467-7119

Provider Business Practice Location Address
First Line	:	1211 CHESTNUT ST STE 405
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4114
Country	:	US
Telephone Number	:	215-971-2804
Fax Number	:	215-665-8018

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

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	05/06/2024

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Directions to “ GINA CARLOTTI MD” Practice Location

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