Provider Demographics
NPI:1053708107
Name:WISE HEALTHCARE SERVICES INC.
Entity type:Organization
Organization Name:WISE HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAILAKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-467-5444
Mailing Address - Street 1:850 N KINTYRE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-7533
Mailing Address - Country:US
Mailing Address - Phone:714-467-5444
Mailing Address - Fax:
Practice Address - Street 1:850 N KINTYRE DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-7533
Practice Address - Country:US
Practice Address - Phone:714-467-5444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health