Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kidisti Ghebre Mariam, OD

Individual provider Optometrist · NPI 1477508331

Kidisti Ghebre Mariam, OD is an Optometrist in Antioch, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

2201 Verne Roberts Cir
Antioch, CA 94509-7911
Phone: (925) 757-1183
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 11703T (CA)

Record details

NPI number1477508331
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorNo
NPI enumeratedMay 22, 2006
Last updated in NPPESJuly 13, 2026

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