IndividualActive
Mydung Phan, NUTRITIONIST
NPI 1245065945 · Driver · Glendale, AZ
Provider details
- NPI number
- 1245065945
- Entity type
- Individual
- Primary specialty
- DriverOther Service Providers
- Credential
- NUTRITIONIST
- Sex
- Female
- Sole proprietor
- No
Mailing address
6637 N 58th Dr Apt 3
Glendale, AZ 85301-3900
Registry dates
- Enumerated
- 2024-09-04
- Last updated
- 2025-02-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.