Mydung T Phan, NUTRITIONIST

Primary specialty

DriverTaxonomy code 172A00000X

Practice address

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

Phone

(623) 624-5179

NPI assigned

Sep 4, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glendale Redbird Co

  • Nutritionist
  • Glendale, AZ
  • NPI 1598590291
  NPD Authorized official
• Glendale Redbird Co

  • Driver
  • Glendale, AZ
  • NPI 1780489112
  NPD Authorized official

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1245065945",
    "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": "623-624-5179"
        },
        {
            "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": "623-624-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "MYDUNG",
        "middle_name": "T",
        "credential": "NUTRITIONIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Huong Thu Pham, D.M.D.
• Kieuanh T Pham, R.N.
• Michael Nhan Vo Pham, PHARMACIST
• Tam Minh Pham
• Eirene Hoang Uyen Phan
• Truce Phan, PHARM. D
• Phandinh Clinic-Urgent Care & Wellness Center PC
• Phandinh Clinic-Urgent Care and Wellness Center PC
• Craig Matthew Phelps, DO
• Samantha Philbrook, RBT

• Driver in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Driver in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.