NPIMap

Organization Active NPI

Benevolence Industries Incorporated

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1376761940
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
Practice address
3533 W. Pico Boulevard
Los Angeles, CA 90019
Phone
(323) 734-1600
Fax
(323) 734-1666
NPI assigned
Apr 21, 2007
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
Mr. Kwabena Obeng
Title
Chief Executive Officer
Phone
(310) 800-7963

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Clinic/Center 261Q00000X 550001067 CA
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3533 W. Pico Boulevard
Los Angeles, CA 90019

Mailing address

3533 W Pico Blvd
Los Angeles, CA 90019-4534
Phone (323) 734-1600

Other identifiers 1

IdentifierTypeStateIssuer
1376761940MedicaidCA

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
O20130520000146 CA Part A Provider - Federally Qualified Health Center (FQHC) 3870686611 Practice locations: Los Angeles, CA

Federally qualified health center certification: CCN 751016

Legal name
BENEVOLENCE INDUSTRIES INCORPORATED
Doing business as
CENTRAL MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 20, 2013
Last certification
May 20, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 15, 2005 in CA
Enrollment address
3533W Pico Blvd
Los Angeles, CA 90019-4534

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.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1066931Benevolence Industries Incorporated3533 W Pico Blvd, Los Angeles, CA 90019Certificate of waiverApr 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Benevolence Industries Incorporated13 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 10

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

NameRoleSinceShare
Allison Norton Individual Corporate Director Aug 1, 2011
Salisu a Aikoye Individual Corporate Director Aug 1, 2011
Fern Stamps Individual Corporate Director Dec 6, 2014
Michael Tetteh Individual Corporate Director Aug 1, 2011
Ernestine Smith Individual Corporate Director Aug 1, 2011
Kwabena Obeng Individual Contracted Managing Employee Jan 1, 2013
5% Or Greater Direct Ownership InterestPresident Aug 1, 2007 10%
W-2 Managing EmployeePresident & Ceo Jan 1, 2013
Other Aug 17, 2005 100%
Edward Frimpong Individual Corporate Director Aug 1, 2011
Rebekah Jennings Individual Corporate Director Aug 1, 2011
Emmanuel Freduah Agyemang Individual W-2 Managing Employee Jan 1, 2017
Thomas Adueni Individual Corporate Director Aug 1, 2011

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Benevolence Health CenterAnaheim, CA, CCN 921187 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 8, 2014
Jul 8, 2014
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 4

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1376761940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900194534",
            "telephone_number": "323-734-1600",
            "fax_number": "323-734-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 W. PICO BOULEVARD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90019",
            "telephone_number": "323-734-1600",
            "fax_number": "323-734-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENEVOLENCE INDUSTRIES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-21",
        "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": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "310-800-7963",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "550001067",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376761940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.