Provider Demographics
NPI:1467749531
Name:ALBA, KRISTINE MARGARET ASIS (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINE MARGARET
Middle Name:ASIS
Last Name:ALBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTINE MARGARET
Other - Middle Name:ASIS
Other - Last Name:ALBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:24 J. M. BASA STREET
Mailing Address - Street 2:FATIMA BUILDING
Mailing Address - City:ILOILO CITY
Mailing Address - State:ILOILO
Mailing Address - Zip Code:5000
Mailing Address - Country:PH
Mailing Address - Phone:6333-338-1155
Mailing Address - Fax:
Practice Address - Street 1:24 J. M. BASA STREET
Practice Address - Street 2:FATIMA BUILDING
Practice Address - City:ILOILO CITY
Practice Address - State:ILOILO
Practice Address - Zip Code:5000
Practice Address - Country:PH
Practice Address - Phone:6333-338-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125060644208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics