0001783087-19-000001.txt : 20190724 0001783087-19-000001.hdr.sgml : 20190724 20190724123636 ACCESSION NUMBER: 0001783087-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190724 DATE AS OF CHANGE: 20190724 EFFECTIVENESS DATE: 20190724 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Clever Care Health Plan, Inc. CENTRAL INDEX KEY: 0001783087 IRS NUMBER: 832354214 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-344956 FILM NUMBER: 19970026 BUSINESS ADDRESS: STREET 1: 1040 S. MOUNT VERNON AVENUE STREET 2: SUITE F CITY: COLTON STATE: CA ZIP: 92324 BUSINESS PHONE: 657-221-0285 MAIL ADDRESS: STREET 1: 1040 S. MOUNT VERNON AVENUE STREET 2: SUITE F CITY: COLTON STATE: CA ZIP: 92324 D 1 primary_doc.xml X0708 D LIVE 0001783087 Clever Care Health Plan, Inc. 1040 S. MOUNT VERNON AVENUE SUITE F COLTON CA CALIFORNIA 92324 657-221-0285 CALIFORNIA None None Corporation true 2018 Dave Firdaus 1040 S. Mount Vernon Avenue Suite F Colton CA CALIFORNIA 92324 Executive Officer Director Hiep Dinh Pham 1040 S. Mount Vernon Avenue Suite F Colton CA CALIFORNIA 92324 Executive Officer Director Myong Sun Lee 1040 S. Mount Vernon Avenue Suite F Colton CA CALIFORNIA 92324 Executive Officer Director Other Health Care No Revenues 06b false 2019-04-19 false true Convertible promissory notes false 0 250000 0 250000 false 3 0 0 0 false Clever Care Health Plan, Inc. Daniel Nguyen Daniel Nguyen Attorney-in-Fact 2019-07-24