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