NPIMap

Organization Active NPI

Benevolence Industries Incorporated

Doing business as Benevolence Health Center

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
National Provider Identifier
1043621220
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BENEVOLENCE INDUSTRIES INCORPORATED
Doing business as
Benevolence Health Center
Practice address
303 N East St
Anaheim, CA 92805-3341
Phone
(714) 491-1771
NPI assigned
May 9, 2014
Last updated
Mar 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Authorized official

Name
Kwabena Obeng
Title
Ceo/ President
Phone
(310) 800-7963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

303 N East St
Anaheim, CA 92805-3341

Mailing address

303 N East St
Anaheim, CA 92805-3341
Phone (714) 491-1771

Other names 1

  • Benevolence Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070910000638 CA Part B Supplier - Clinic/Group Practice 3870686611 Receives reassigned benefits from 13 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sylmar, CA; Orange, CA; Los Angeles, CA; Long Beach, CA; Compton, CA; Anaheim, CA
O20191024002904 CA Part A Provider - Federally Qualified Health Center (FQHC) 3870686611 Practice locations: Anaheim, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043621220. Details of each certification follow.

Federally qualified health center certification: CCN 921187

Legal name
BENEVOLENCE INDUSTRIES INCORPORATED
Doing business as
BENEVOLENCE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 4, 2019
Last certification
Nov 4, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 17, 2005 in CA
Enrollment address
303 N East St
Anaheim, CA 92805-3341

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Benevolence Industries13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Fern Stamps Individual Corporate DirectorBoard Member Jul 8, 2014 100%
Benevolence Industries Incorporated Organization, Torrance, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 8, 2014 100%
Operational/Managerial Control Jul 8, 2014 100%
Ernestine Smith Individual Corporate DirectorBoard Chairperson Jul 8, 2014 100%
Kwabena Obeng Individual Corporate OfficerCeo/President Jul 8, 2014 100%
W-2 Managing EmployeeCeo/President Jul 8, 2014 100%
Operational/Managerial ControlCeo/President Jul 8, 2014 100%
Edward Frimpong Individual Corporate DirectorBoard Member Jul 8, 2014 100%
Frank Koomson Individual Corporate OfficerCoo Jul 8, 2014 100%
W-2 Managing EmployeeCoo Jul 8, 2014 100%
Operational/Managerial ControlCoo Jul 8, 2014 100%
Rebekah Jennings Individual Corporate DirectorBoard Member Jul 8, 2014 100%
Emmanuel Freduah Agyemang Individual Corporate OfficerCfo Aug 1, 2016 100%
W-2 Managing EmployeeCfo Aug 1, 2016 100%
Operational/Managerial ControlCfo Aug 1, 2016 100%

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Benevolence Health CenterOrange, CA, CCN 921188 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 12, 2014
May 12, 2014
Benevolence Health CenterLong Beach, CA, CCN 921189 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 3, 2014
Feb 3, 2014
Benevolence Health CenterLos Angeles, CA, CCN A01015 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 5, 2014
May 5, 2014

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1043621220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N EAST ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053341",
            "telephone_number": "714-491-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N EAST ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053341",
            "telephone_number": "714-491-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENEVOLENCE INDUSTRIES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-09",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A",
        "authorized_official_last_name": "OBENG",
        "authorized_official_first_name": "KWABENA",
        "authorized_official_title_or_position": "CEO/ PRESIDENT",
        "authorized_official_telephone_number": "310-800-7963"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benevolence Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Benevolence Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.