1467749531 NPI number — KRISTINE MARGARET ASIS ALBA M.D.

Table of content: KRISTINE MARGARET ASIS ALBA M.D. (NPI 1467749531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467749531 NPI number — KRISTINE MARGARET ASIS ALBA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBA
Provider First Name:
KRISTINE MARGARET
Provider Middle Name:
ASIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALBA
Provider Other First Name:
KRISTINE MARGARET
Provider Other Middle Name:
ASIS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1467749531
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24 J. M. BASA STREET
Provider Second Line Business Mailing Address:
FATIMA BUILDING
Provider Business Mailing Address City Name:
ILOILO CITY
Provider Business Mailing Address State Name:
ILOILO
Provider Business Mailing Address Postal Code:
5000
Provider Business Mailing Address Country Code:
PH
Provider Business Mailing Address Telephone Number:
63333381155
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 J. M. BASA STREET
Provider Second Line Business Practice Location Address:
FATIMA BUILDING
Provider Business Practice Location Address City Name:
ILOILO CITY
Provider Business Practice Location Address State Name:
ILOILO
Provider Business Practice Location Address Postal Code:
5000
Provider Business Practice Location Address Country Code:
PH
Provider Business Practice Location Address Telephone Number:
63333381155
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  125060644 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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