Mydung T. Phan, NUTRITIONIST
NPI 1245065945ActiveIndividual· Driver· Glendale, AZ
Driver (NUTRITIONIST) in Glendale, Arizona, with an NPI issued in September 2024.
Overview
| NPI | 1245065945 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | NUTRITIONIST |
| Sole proprietor | No |
| NPI issued | Sep 4, 2024 |
| Last updated in NPPES | Feb 18, 2025 |
| Certified by provider | Feb 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Driver Primary | 172A00000X | — | AZ |
| Nutritionist | 133N00000X | — | — |
| Nutritionist, Nutrition, Education | 133NN1002X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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