Organization
HAIDER SPINE CENTER MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS T HAIDER M.D. (PRESIDENT)
(951) 413-0964
Entity
Organization
Contact information
Practice address
6276 RIVER CREST DR, RIVERSIDE, CA 92507-0754
(952) 141-3020
(951) 653-5161
Mailing address
6276 RIVER CREST DR STE A, RIVERSIDE, CA 92507-0754
(951) 413-0200
(951) 653-5161
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
20A8197
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
A107599
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
G61537
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
G81353
CA
363AS0400X
Surgical Physician Assistant
PA18101
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740213594
CHAD SWEETNAM
CA
05
—
GR0086790
—
CA
Enumeration date
03/29/2006
Last updated
12/09/2025
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