Individual provider Active NPI

Robert V Zedelis, M.D.

  • Specialist
  • Eureka, CA
National Provider Identifier
1083614549
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G17001 Issued in CA
Practice address
2425 Harrison Ave
Eureka, CA 95501-3218
Phone
(707) 441-4420
Fax
(707) 269-3889
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G17001 CA Primary

Addresses

Primary practice location

2425 Harrison Ave
Eureka, CA 95501-3218

Mailing address

PO Box 6860
Eureka, CA 95502-6860
Phone (707) 443-3384

Other identifiers 1

IdentifierTypeStateIssuer
GR0065800MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G17001CAMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083614549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6860",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955026860",
            "telephone_number": "707-443-3384",
            "fax_number": "707-443-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013218",
            "telephone_number": "707-441-4420",
            "fax_number": "707-269-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEDELIS",
        "first_name": "ROBERT",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G17001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.