Individual provider Active NPI

Angela Mayann Cunanan, OD

  • Optometrist
  • San Bernardino, CA
National Provider Identifier
1093491193
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35644 Issued in CA
Practice address
2195 Club Center Dr Ste L
San Bernardino, CA 92408-4162
Phone
(909) 558-2154
Fax
(909) 835-1760
NPI assigned
Jun 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.007182 OH
Optometrist 152W00000X OPT35644 CA Primary

Addresses

Primary practice location

2195 Club Center Dr Ste L
San Bernardino, CA 92408-4162

Mailing address

11370 Anderson St Unit 1800
Loma Linda, CA 92354-3450
Phone (909) 558-2154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919003775 CA Practitioner - Optometry 6406397298 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT35644CAMDOptometrist
OPT.007182OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 16, 2025 Accepting new patients
Sansum Clinic CurrentSince Aug 19, 2024 Accepting new patients
Sansum Clinic Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 16, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm Optometrist Current Accepting new patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System CurrentSince Sep 24, 2025 Accepting new patients
Sansum Clinic CurrentSince Aug 19, 2024 Accepting new patients
Sac Health System CurrentSince Sep 24, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

11370 Anderson St
Unit 1800
Loma Linda, CA 92354

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

4151 Foothill Rd
Santa Barbara, CA 93110
Phone (805) 681-1760

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

2195 Club Center Dr
Ste L
Sn Bernrdno, CA 92408
Phone (909) 558-2154

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750

Interoperability endpoints

  • Direct secure messaging: alin760607@hisp.ehr.sutterhealth.org
  • Direct secure messaging: alin1267493@direct.llu.edu

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1093491193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST UNIT 1800",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2154",
            "fax_number": "909-835-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 CLUB CENTER DR STE L",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084162",
            "telephone_number": "909-558-2154",
            "fax_number": "909-835-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNANAN",
        "first_name": "ANGELA",
        "middle_name": "MAYANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007182",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.