MEDICARE: MAHENDER VYASABATTU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	40143	KY
2	208M00000X	Hospitalist Physician	CA179354	CA
3	208M00000X	Hospitalist Physician	40143	KY

General Provider Information

NPI Number	:	1386689479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHENDER VYASABATTU MD

Provider Business Mailing Address
First Line	:	3415 VIA CABO VERDE
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92029-7457
Country	:	US
Telephone Number	:	858-888-1553
Fax Number	:

Provider Business Practice Location Address
First Line	:	UK INTERNAL MEDICINE-HOSPITALISTS
Second Line	:	800 ROSE ST
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0293
Country	:	US
Telephone Number	:	859-323-6047
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	05/06/2026

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