0001937458-22-000002.txt : 20221130 0001937458-22-000002.hdr.sgml : 20221130 20221130172236 ACCESSION NUMBER: 0001937458-22-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20221130 DATE AS OF CHANGE: 20221130 EFFECTIVENESS DATE: 20221130 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Pearl SurgiCenter, LLC CENTRAL INDEX KEY: 0001937458 IRS NUMBER: 204122597 STATE OF INCORPORATION: OR FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-466211 FILM NUMBER: 221436367 BUSINESS ADDRESS: STREET 1: 120 NW 14TH AVE CITY: PORTLAND STATE: OR ZIP: 97209 BUSINESS PHONE: (503) 771-1883 MAIL ADDRESS: STREET 1: 120 NW 14TH AVE CITY: PORTLAND STATE: OR ZIP: 97209 D 1 primary_doc.xml X0708 D LIVE 0001937458 Pearl SurgiCenter, LLC 120 NW 14TH AVE PORTLAND OR OREGON 97209 (503) 771-1883 OREGON None None Limited Liability Company true Richard Rosenfield, M.D. 120 NW 14th Ave Portland OR OREGON 97209 Executive Officer Director Promoter Richard Brandes, M.D. 120 NW 14th Ave Portland OR OREGON 97209 Director Peter Billing, M.D. 120 NW 14th Ave Portland OR OREGON 97209 Director Maxwell Furr, M.D. 120 NW 14th Ave Portland OR OREGON 97209 Director Kuo Wei Ho, M.D. 120 NW 14th Ave Portland OR OREGON 97209 Director Timothy Mineo, M.D. 120 NW 14th Ave Portland OR OREGON 97209 Director Andrew Patel, M.D. 120 NW 14th Ave Portland OR OREGON 97209 Director Daniel Tseng, M.D. 120 NW 14th Ave Portland OR OREGON 97209 Director Michael Owens 120 NW 14th Ave Portland OR OREGON 97209 Executive Officer Director Other Health Care Decline to Disclose 06b false 2022-11-02 false true false 0 169742 169742 0 false 4 0 0 0 false Pearl SurgiCenter, LLC /s/ Richard Rosenfield, M.D. Richard Rosenfield, M.D. President 2022-11-30