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Licensing details for: 14204

Name: GHALILI, MARK MAZIAR

License Type: Osteopathic Physician and Surgeon 20A

Primary Status: License Renewed & Current Primary Status Definition

School Name: WesternU College of Osteopathic Medicine of the Pacific

Graduation Year: 2012

Address of Record

9201 W Sunset Blvd Ste 912
WEST HOLLYWOOD CA 90069-3710
LOS ANGELES county
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Issuance Date

August 11, 2015

Expiration Date

July 31, 2027

Current Date / Time

August 10, 2026
8:03:24 AM

Public Record Actions

Survey Information

The following information is self-reported by the licensee and has not been verified by the Board.

Current Training Status
Not in Training
Postgraduate Training Years
8
Primary Area of Practice
Internal Medicine
Secondary Area of Practice
Not Applicable
ABMS Certifications
American Board of Internal Medicine - Internal Medicine
AOA Certifications
Other - None
Are you retired?
No
Practice Activities
Direct Patient Care (including telehealth) - 20-29 Hours
Percentage (%) of patient care hours spent on telehealth - 0
Training - 1-9 Hours
Research - 1-9 Hours
Administration - 1-9 Hours
Other - Decline to State
Primary Practice Location
Zip - 90069
United States Primary Practice Location
Secondary Practice Location
Not Applicable
Are you Hispanic, Latino/a, or of Spanish origin?
Decline to State
Race
Decline to State
Language Fluency
Decline to State
Gender Identity
Male

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