Provider Demographics
NPI:1306040373
Name:CARLOTTI, GINA (MD)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:CARLOTTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6255 W SUNSET BLVD FL 21
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7422
Mailing Address - Country:US
Mailing Address - Phone:323-860-5200
Mailing Address - Fax:323-467-7119
Practice Address - Street 1:1211 CHESTNUT ST STE 405
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4114
Practice Address - Country:US
Practice Address - Phone:215-971-2804
Practice Address - Fax:215-665-8018
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2024-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT54526207Q00000X
PAMD439263207Q00000X
NC141045207Q00000X, 207P00000X
NJ25MA08755800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine