Healthcare Provider Details

I. General information

NPI: 1528949286
Provider Name (Legal Business Name): NOUR WELLNESS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27776 SAN PASQUAL ST
MISSION VIEJO CA
92692-6108
US

IV. Provider business mailing address

27776 SAN PASQUAL ST
MISSION VIEJO CA
92692-6108
US

V. Phone/Fax

Practice location:
  • Phone: 949-836-6083
  • Fax:
Mailing address:
  • Phone: 949-836-6083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELHAM FOROUZESH
Title or Position: PROGRAM DIRECTVOR
Credential: PHD
Phone: 949-836-6083