Individual ProviderRay R. MahoubiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address6036 N 19th Ave, Suite 402, Phoenix, AZ 85015-2106(602) 249-0115PECOS EnrollmentBased on the most recent information from CMS, provider Ray R. Mahoubi does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1184676504Provider TypeIndividualFull NameMahoubi, Ray R.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/16/2006Last Updated9/21/2016Contact InformationPractice LocationPractice Address6036 N 19th Ave, Suite 402, Phoenix, AZ 85015-2106Phone(602) 249-0115Fax(602) 246-7029Mailing LocationMailing AddressPO Box 35380, Las Vegas, NV 89133-5380Phone(602) 249-0115Fax(602) 246-0837Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense23416Arizona