Active NPI 1245065945 Individual Practitioner Female Practitioner

Mydung T Phan , NUTRITIONIST

Driver • Glendale, AZ

Professional Overview & Biography Verified Profile Summary

Mydung Phan, NUTRITIONIST is a registered healthcare professional specializing in Driver in Glendale, AZ. Practice services are available at 6637 N 58TH DR APT 3 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6637 N 58th Dr Apt 3

Glendale, AZ 853013900

Telephone 6236245179

Associated Practice Facility / Clinic

🏢 Mydung Phan Facility NPI 1083429369

Specialty Benchmarks & Practice Insights

Comparative analytics for Driver in Glendale, AZ

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 10.2 Yrs

Regional Practice Density

6 Specialists

Practicing in Glendale, AZ (109 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-02-18

Driver Primary Specialty

NUCC Taxonomy Code: 172A00000X

A person employed to operate a motor vehicle as a carrier of persons or property.

Nutritionist

NUCC Taxonomy Code: 133N00000X

A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation.

Nutritionist - Nutrition, Education

NUCC Taxonomy Code: 133NN1002X

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 18, 2025

Nutritionist

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 12, 2024

Nutritionist

✅

NPI Profile Active September 04, 2024

NPI status registered as active in NPPES database

📍

Updated Practice Location September 04, 2024

Registered at 6637 N 58TH DR APT 3, GLENDALE, AZ 853013900 (Tel: 6236245179)

📍

Updated Business Mailing Address September 04, 2024

Registered at 6637 N 58TH DR APT 3, GLENDALE, AZ 853013900 (Tel: 6236245179)

👤

Provider Name / Credentials Updated September 04, 2024

Recorded as MYDUNG PHAN, NUTRITIONIST

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 04, 2024

Driver

🟢

Initial NPI Registration & Enumeration September 04, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1245065945

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 04, 2024

Last Update: February 18, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

6637 N 58th Dr Apt 3

Glendale, AZ 853013900

Phone: 6236245179

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.