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

Mydung T Phan, NUTRITIONIST

Individual provider Nutritionist · NPI 1245065945

Mydung T Phan, NUTRITIONIST is a Nutritionist in Glendale, Arizona. Licensed in Arizona. Registered with an NPI since 2024.

Licensed in
AZ
In the registry since
2024
Specialties on file
3

Practice location Address checks out

6637 N 58th Dr Apt 3
Glendale, AZ 85301-3900
Phone: (623) 624-5179
Show map & directions

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

Specialties & licences

Driver (primary) Taxonomy 172A00000X (AZ)
Nutritionist Taxonomy 133N00000X
Nutrition Education Nutritionist Taxonomy 133NN1002X

Record details

NPI number1245065945
Entity typeIndividual (Type 1)
GenderFemale
Credentials NUTRITIONIST
Sole proprietorNo
NPI enumeratedSeptember 4, 2024
Last updated in NPPESFebruary 18, 2025
Certification dateFebruary 18, 2025

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