Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mydung Phan

Organization Nutritionist · NPI 1083429369

Mydung Phan is a Nutritionist in Glendale, Arizona. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
6

Practice location Address checks out

6637 N 58th Dr Apt 3
Glendale, AZ 85301-3900
Phone: (480) 918-4775
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X
Nutritionist Taxonomy 133N00000X
Obesity and Weight Management Nutrition Registered Dietitian Taxonomy 133VN1201X
Registered Dietetic Technician Taxonomy 136A00000X
Health & Wellness Coach Taxonomy 171400000X
Driver Taxonomy 172A00000X

Record details

NPI number1083429369
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationRadadvantage a Professional Corporation
Authorized official Mydung Phan — Registered Nutrionist · (480) 918-4775
Other names Mydung Phan; Mydung Thi Phan
NPI enumeratedFebruary 12, 2025
Last updated in NPPESFebruary 16, 2025
Certification dateFebruary 16, 2025
Mailing address6637 N 58th Dr Apt 3, Glendale, AZ 85301-3900

Other providers in Glendale