Maziar Mark Ghalili, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

SL0884 Issued in NV

Practice address

2101 S San Pedro St
Los Angeles, CA 90011-1125

Phone

(702) 671-2341

NPI assigned

Jun 6, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mark Ghalili Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mghalili347224@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospitalist Medicine Physicians of California, Inc

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1184663965
  Medicare reassignment NPD
• Tarzana Treatment Centers, Inc.

  • Community/Behavioral Health Agency
  • Lancaster, CA
  • NPI 1346842093
  Medicare reassignment NPD
• Tarzana Treatment Centers, Inc.

  • Multi-Specialty Clinic/Center
  • Palmdale, CA
  • NPI 1619702099
  NPD
• Sam Ghalili MD Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1720453574
  NPD (past)
• Saman Ghalili MD Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1366735813
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1053672006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S SAN PEDRO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900111125",
            "telephone_number": "702-671-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S SAN PEDRO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900111125",
            "telephone_number": "702-671-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHALILI",
        "first_name": "MAZIAR",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "SL0884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "GHALILI",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Setareh Ghahremani
• Anchal Ghai, M.D.
• Paria Ghalavand
• Ojan Ghalchi, DMD
• Mohammad Ghalichi, M.D.
• Saman Ghalili, M.D.
• Steven Ghalili, MD
• Nare Ghaltakhchyan
• Azmy F Ghaly, MEDICAL DOCTOR
• Maged Ghaly

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.