0001437749-25-014028.txt : 20250501 0001437749-25-014028.hdr.sgml : 20250501 20250501123414 ACCESSION NUMBER: 0001437749-25-014028 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20250501 DATE AS OF CHANGE: 20250501 EFFECTIVENESS DATE: 20250501 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Provisio Medical, Inc. CENTRAL INDEX KEY: 0001685703 ORGANIZATION NAME: EIN: 200305318 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-544975 FILM NUMBER: 25901173 BUSINESS ADDRESS: STREET 1: 10449 HUNTERS RIDGE PLACE CITY: SAN DIEGO STATE: CA ZIP: 92127 BUSINESS PHONE: 5087409940 MAIL ADDRESS: STREET 1: 10449 HUNTERS RIDGE PLACE CITY: SAN DIEGO STATE: CA ZIP: 92127 D 1 primary_doc.xml X0708 D LIVE 0001685703 Provisio Medical, Inc. 10815 Rancho Bernardo Road Suite 110 San Diego CA CALIFORNIA 92127 (858) 524-3901 DELAWARE None None Corporation true Stephen Eric Ryan c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Executive Officer Director Promoter John McCallum JAM Captial Partners PO Box 20097 St. Simons Island GA GEORGIA 31522 Director Aurelio Fernandez c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Director Michael Chobotov c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Director Other Technology Decline to Disclose 06b false 2025-04-21 false true false 50000 3000000 1313500 1686500 false 4 0 0 150000 true false Provisio Medical, Inc. /s/ Stephen Eric Ryan Stephen Eric Ryan President 2025-05-01