0001783087-20-000002.txt : 20200505 0001783087-20-000002.hdr.sgml : 20200505 20200504190104 ACCESSION NUMBER: 0001783087-20-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20200505 DATE AS OF CHANGE: 20200504 EFFECTIVENESS DATE: 20200505 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Clever Care Health Plan, Inc. CENTRAL INDEX KEY: 0001783087 IRS NUMBER: 832354214 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-366264 FILM NUMBER: 20846369 BUSINESS ADDRESS: STREET 1: 8990 WESTMINSTER BOULEVARD STREET 2: 3RD FLOOR CITY: WESTMINSTER STATE: CA ZIP: 92683 BUSINESS PHONE: 657-224-1188 MAIL ADDRESS: STREET 1: 8990 WESTMINSTER BOULEVARD STREET 2: 3RD FLOOR CITY: WESTMINSTER STATE: CA ZIP: 92683 D 1 primary_doc.xml X0708 D LIVE 0001783087 Clever Care Health Plan, Inc. 8990 WESTMINSTER BOULEVARD 3RD FLOOR WESTMINSTER CA CALIFORNIA 92683 657-224-1188 DELAWARE None None Corporation true 2018 Dave Firdaus 8990 Westminster Boulevard 3rd Floor Westminster CA CALIFORNIA 92683 Executive Officer Director Hiep Dinh Pham 8990 Westminster Boulevard 3rd Floor Westminster CA CALIFORNIA 92683 Executive Officer Director Myong Sun Lee 8990 Westminster Boulevard 3rd Floor Westminster CA CALIFORNIA 92683 Executive Officer Director Other Health Care No Revenues 06b false 2020-02-18 false true false 0 17829999 17829999 0 false 6 0 0 0 false Clever Care Health Plan, Inc. /s/ Daniel X. Nguyen Daniel Nguyen Attorney-in-Fact 2020-05-04