Individual
ALEX JASON VANDER VORSTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
24255 PACIFIC COAST HWY, PEPPERDINE ATHLETICS - SPORTS MEDICINE, MALIBU, CA 90263
(310) 506-4169
(310) 506-4424
Mailing address
24255 PACIFIC COAST HWY, PEPPERDINE ATHLETICS - SPORTS MEDICINE, MALIBU, CA 90263
(310) 506-4169
(310) 506-4424
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000017845
CA
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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