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Contact Information

ALEX J VANDER VORSTE, MS, ATC
24255 PACIFIC COAST HWY
PEPPERDINE ATHLETICS - SPORTS MEDICINE
MALIBU, CA90263
 Phone: 310-506-4169
 Fax: 310-506-4424
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for ALEX J VANDER VORSTE · (Male)

NPI Number 1104431451
Status Active
Credentials MS, ATC
Entity Individual
Enumeration date 09/14/2020
Last updated 09/14/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 2000017845
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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