NPI 1245065945

Mydung T Phan, NUTRITIONIST

Practitioner Driver Glendale, AZ

Practice location

Address: 6637 N 58th Dr APT 3, Glendale, AZ 85301-3900
Phone: (623) 624-5179

Registered specialties (3)

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Nutritionist

Dietary & Nutritional Service Providers Taxonomy 133N00000X

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Nutrition Education Nutritionist

Dietary & Nutritional Service Providers Taxonomy 133NN1002X

Registry record

NPI: 1245065945
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Sep 2024
Record last updated: 18 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.