Healthcare Provider Details

I. General information

NPI: 1821798729
Provider Name (Legal Business Name): MADISON TAYLOR KOLAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADISON TAYLOR MEALEY PA-C

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 COFFEE RD STE 100
BAKERSFIELD CA
93309-1273
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 661-885-6065
  • Fax: 661-885-6085
Mailing address:
  • Phone: 515-643-8100
  • Fax: 515-643-8139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number68908
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number126468
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: