0001403114-12-000001.txt : 20121001
0001403114-12-000001.hdr.sgml : 20121001
20121001135950
ACCESSION NUMBER: 0001403114-12-000001
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: Rule 506
FILED AS OF DATE: 20121001
DATE AS OF CHANGE: 20121001
EFFECTIVENESS DATE: 20121001
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: Interventional Spine Inc
CENTRAL INDEX KEY: 0001403114
IRS NUMBER: 000000000
STATE OF INCORPORATION: CA
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-184846
FILM NUMBER: 121119455
BUSINESS ADDRESS:
STREET 1: 13700 Alton Parkway
CITY: Irvine
STATE: CA
ZIP: 92618
BUSINESS PHONE: 949-581-7250
MAIL ADDRESS:
STREET 1: 13700 Alton Parkway
CITY: Irvine
STATE: CA
ZIP: 92618
D
1
primary_doc.xml
X0706
D
LIVE
0001403114
Interventional Spine Inc
13700 Alton Parkway
Suite 160
Irvine
CA
CALIFORNIA
92618
949-472-0006
CALIFORNIA
Triage Medical, Inc.
Anchor Medical Technologies, Inc.
None
Corporation
true
Walter
A.
Cuevas
13700 Alton Parkway
Suite 160
Irvine
CA
CALIFORNIA
92618
Executive Officer
Director
Franklin
D.
Brown
13700 Alton Parkway
Suite 160
Irvine
CA
CALIFORNIA
92618
Director
Michael
R.
Henson
13700 Alton Parkway
Suite 160
Irvine
CA
CALIFORNIA
92618
Director
Ashton
Hudson
13700 Alton Parkway
Suite 160
Irvine
CA
CALIFORNIA
92618
Director
Paul
Mieyal
13700 Alton Parkway
Suite 160
Irvine
CA
CALIFORNIA
92618
Director
Thomas
Thaler
13700 Alton Parkway
Suite 160
Irvine
CA
CALIFORNIA
92618
Director
Stephen
Wilson
13700 Alton Parkway
Suite 160
Irvine
CA
CALIFORNIA
92618
Director
Other Technology
Decline to Disclose
- 06
false
2012-09-25
false
true
true
true
false
0
4000000
1642700
2357300
false
44
0
0
0
false
Interventional Spine Inc
/s/ Walter A. Cuevas
Walter A. Cuevas
Chief Executive Officer
2012-09-27