0001937458-23-000001.txt : 20230502
0001937458-23-000001.hdr.sgml : 20230502
20230502163232
ACCESSION NUMBER: 0001937458-23-000001
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: 06b
FILED AS OF DATE: 20230502
DATE AS OF CHANGE: 20230502
EFFECTIVENESS DATE: 20230502
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: 021-480613
FILM NUMBER: 23879651
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
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, M.D.
120 NW 14th AVE
Portland
OR
OREGON
97209
Director
Richard
Rosenfield, M.D.
120 NW 14th AVE
Portland
OR
OREGON
97209
Executive Officer
Director
Promoter
Other Health Care
Decline to Disclose
- 06b
false
2023-03-10
false
true
false
0
39172
39172
0
false
1
0
0
0
false
Pearl SurgiCenter, LLC
/s/ Richard Rosenfield, M.D.
Richard Rosenfield, M.D.
President
2023-05-02