0001657369-19-000001.txt : 20191105 0001657369-19-000001.hdr.sgml : 20191105 20191105130336 ACCESSION NUMBER: 0001657369-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20191105 DATE AS OF CHANGE: 20191105 EFFECTIVENESS DATE: 20191105 FILER: COMPANY DATA: COMPANY CONFORMED NAME: MD Revolution, Inc. CENTRAL INDEX KEY: 0001657369 IRS NUMBER: 452485559 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-352623 FILM NUMBER: 191192562 BUSINESS ADDRESS: STREET 1: 9191 TOWNE CENTRE DR. SUITE 510 CITY: SAN DIEGO STATE: CA ZIP: 92122 BUSINESS PHONE: 858-847-5064 MAIL ADDRESS: STREET 1: 9191 TOWNE CENTRE DR. SUITE 510 CITY: SAN DIEGO STATE: CA ZIP: 92122 D 1 primary_doc.xml X0708 D LIVE 0001657369 MD Revolution, Inc. 9191 TOWNE CENTRE DR. SUITE 510 SAN DIEGO CA CALIFORNIA 92122 858-847-5064 DELAWARE MDRevolution LLC La Jolla Institute of Personalized Medicine L MDRevolution, Inc. None Corporation true Parker Hinshaw c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Executive Officer Director Samir Damani c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Executive Officer Director Jason Felger c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Director Jean Balgrosky c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Executive Officer Director Other Decline to Disclose 06b false 2019-10-21 false true false 0 3000000 2475786 524214 false 27 0 0 0 false MD Revolution, Inc. /s/ Parker Hinshaw Parker Hinshaw Chief Executive Officer 2019-11-05