Healthcare Provider Details

I. General information

NPI: 1386581809
Provider Name (Legal Business Name): NURI GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1082 N LA BREDA ST
COVINA CA
91722-2630
US

IV. Provider business mailing address

1082 N LA BREDA ST
COVINA CA
91722-2630
US

V. Phone/Fax

Practice location:
  • Phone: 213-700-0214
  • Fax: 714-681-1282
Mailing address:
  • Phone: 213-700-0214
  • Fax: 714-681-1282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: OKKYUNG COREAS
Title or Position: OWNER
Credential:
Phone: 213-700-0214