0001140361-17-015416.txt : 20170410 0001140361-17-015416.hdr.sgml : 20170410 20170410153518 ACCESSION NUMBER: 0001140361-17-015416 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170410 DATE AS OF CHANGE: 20170410 EFFECTIVENESS DATE: 20170410 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Patient Insight, Inc. CENTRAL INDEX KEY: 0001668192 IRS NUMBER: 811326892 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-284438 FILM NUMBER: 17753225 BUSINESS ADDRESS: STREET 1: 5482 WILSHIRE BLVD., #159 CITY: LOS ANGELES STATE: CA ZIP: 90036 BUSINESS PHONE: 323-836-2157 MAIL ADDRESS: STREET 1: 5482 WILSHIRE BLVD., #159 CITY: LOS ANGELES STATE: CA ZIP: 90036 D 1 primary_doc.xml X0707 D LIVE 0001668192 Patient Insight, Inc. 5482 WILSHIRE BLVD., #159 LOS ANGELES CA CALIFORNIA 90036 323-836-2157 DELAWARE None None Corporation true 2016 Sarah Sims 5482 Wilshire Blvd. #159 Los Angeles CA CALIFORNIA 90036 Executive Officer Director Chief Executive Officer James Daves 5482 Wilshire Blvd. #159 Los Angeles CA CALIFORNIA 90036 Executive Officer Chief Financial Officer Jesse M. Pines 5482 Wilshire Blvd. #159 Los Angeles CA CALIFORNIA 90036 Executive Officer Director Secretary Other Technology Decline to Disclose 06b false 2017-04-07 false true false 0 825 825 0 Common Stock false 6 0 0 0 false Patient Insight, Inc. /s/ Sarah Sims Sarah Sims CEO 2017-04-04