0001461356-14-000002.txt : 20141021 0001461356-14-000002.hdr.sgml : 20141021 20141020174347 ACCESSION NUMBER: 0001461356-14-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20141021 DATE AS OF CHANGE: 20141020 EFFECTIVENESS DATE: 20141021 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Practice Fusion Inc CENTRAL INDEX KEY: 0001461356 IRS NUMBER: 043838148 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-226813 FILM NUMBER: 141164595 BUSINESS ADDRESS: STREET 1: 300 BEALE STREET SUITE D CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 415-346-7700 MAIL ADDRESS: STREET 1: 300 BEALE STREET SUITE D CITY: SAN FRANCISCO STATE: CA ZIP: 94105 D 1 primary_doc.xml X0707 D LIVE 0001461356 Practice Fusion Inc 650 Townsend Street Suite 500 SAN FRANCISCO CA CALIFORNIA 94103 415-346-7700 DELAWARE None None Corporation true Ryan Howard C/O Practice Fusion, Inc. 650 Townsend Street, Suite 500 San Francisco CA CALIFORNIA 94103 Executive Officer Director Cora Tellez C/O Practice Fusion, Inc. 650 Townsend Street, Suite 500 San Francisco CA CALIFORNIA 94103 Director Michael Harden C/O Practice Fusion, Inc. 650 Townsend Street, Suite 500 San Francisco CA CALIFORNIA 94103 Director Beth Seidenberg C/O Practice Fusion, Inc. 650 Townsend Street, Suite 500 San Francisco CA CALIFORNIA 94103 Director Robert Park C/O Practice Fusion, Inc. 650 Townsend Street, Suite 500 San Francisco CA CALIFORNIA 94103 Executive Officer Other Health Care Decline to Disclose 06b false 2014-10-06 false true true false 1 2500000 2500000 0 false 1 0 0 0 false Practice Fusion Inc /s/ Ryan Howard Ryan Howard President/CEO 2014-10-20