Healthcare Provider Details

I. General information

NPI: 1114048857
Provider Name (Legal Business Name): AVALON FAMILY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 N AVALON BLVD
WILMINGTON CA
90744-1431
US

IV. Provider business mailing address

1626 N AVALON BLVD
WILMINGTON CA
90744-1431
US

V. Phone/Fax

Practice location:
  • Phone: 310-834-4666
  • Fax: 310-834-5538
Mailing address:
  • Phone: 310-834-4666
  • Fax: 310-834-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA41141
License Number StateCA

VIII. Authorized Official

Name: EDGAR IBRAHIM EL SAYAD
Title or Position: MD
Credential:
Phone: 310-325-0600