Mydung Phan

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

MYDUNG PHAN

Doing business as

Mydung Phan

Practice address

6637 N 58TH Dr Apt 3
Glendale, AZ 85301-3900

Phone

(480) 918-4775

NPI assigned

Feb 12, 2025

Organization subpart

Yes

Parent organization

RADADVANTAGE A PROFESSIONAL CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mydung Thi Phan, RDN

Title

Registered Nutrionist

Phone

(480) 918-4775

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 2

• Mydung Phan Doing business as
• Mydung Thi Phan Other name

Part of

Radadvantage a Professional

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Radadvantage a Professional Corporation

  • Diagnostic Radiology Physician
  • Phoenix, AZ
  • NPI 1376719666
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739664000000",
    "number": "1083429369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6637 N 58TH DR APT 3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853013900",
            "telephone_number": "480-918-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6637 N 58TH DR APT 3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853013900",
            "telephone_number": "480-918-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYDUNG PHAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADADVANTAGE A PROFESSIONAL CORPORATION",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "MYDUNG",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "REGISTERED NUTRIONIST",
        "authorized_official_telephone_number": "480-918-4775",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietetic Technician, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167030",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mydung Phan",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mydung Thi Phan",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mercy Warigia Mwangi, ED D BH
• MWC Industries LLC
• Desire Mwemera
• My Wellness LLC
• Ethan Mychajlonka
• Stephanie Myer, DO
• Jennifer J. Myers-Fineberg, D.D.S.
• Alexandra Myers, PA-C
• Antika Tongyoo Myers, FNP-C
• Jamie Alison Myers, BS

• Peer Specialist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Peer Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.