0001250853-22-000118.txt : 20221207 0001250853-22-000118.hdr.sgml : 20221207 20221207190434 ACCESSION NUMBER: 0001250853-22-000118 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221205 FILED AS OF DATE: 20221207 DATE AS OF CHANGE: 20221207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lam Thomas S. CENTRAL INDEX KEY: 0001664499 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37392 FILM NUMBER: 221451161 MAIL ADDRESS: STREET 1: 1668 GARFIELD AVE., 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apollo Medical Holdings, Inc. CENTRAL INDEX KEY: 0001083446 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT CONSULTING SERVICES [8742] IRS NUMBER: 870042699 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1668 S. GARFIELD AVENUE STREET 2: 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 BUSINESS PHONE: (626) 282-0288 MAIL ADDRESS: STREET 1: 1668 S. GARFIELD AVENUE STREET 2: 2ND FLOOR CITY: ALHAMBRA STATE: CA ZIP: 91801 FORMER COMPANY: FORMER CONFORMED NAME: SICLONE INDUSTRIES INC DATE OF NAME CHANGE: 19990413 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2022-12-05 0 0001083446 Apollo Medical Holdings, Inc. AMEH 0001664499 Lam Thomas S. 1668 GARFIELD AVE., 2ND FLOOR ALHAMBRA CA 91801 1 1 0 0 President and Co-CEO Common Stock 2022-12-05 4 M 0 51443 10 A 243270 D Common Stock 2022-12-05 4 M 0 48585 11 A 291855 D Common Stock 1107474 I By the Thomas and Jeanette Lam 2002 Family Trust Common Stock 10191660 I By Allied Physicians of California, A Professional Medical Corporation Warrants to purchase Common Stock 10 2022-12-05 4 M 0 51442.83 D 2017-12-08 2022-12-08 Common Stock 51442.83 0 D Warrants to purchase Common Stock 11 2022-12-05 4 M 0 48585.84 D 2017-12-08 2022-12-08 Common Stock 48585.84 0 D These securities are beneficially owned by Allied Physicians of California, A Profession Medical Corporation, of which the Reporting Person is a director, officer and shareholder. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. On December 8, 2017, a reverse merger transaction between the Issuer and Network Medical Management, Inc. ("NMM") was consummated such that NMM became a wholly-owned subsidiary of the Issuer (the "Merger). Immediately prior to the closing of the Merger, the Reporting Person was a shareholder of NMM. Pursuant to the Merger, the shares of NMM common stock previously held by Reporting Person were converted into (i) 1,563,763 shares of common stock of the Issuer, (ii) a warrant to purchase 48,585.84 shares of common stock of the Issuer at an exercise price of $11.00 per share , (iii) a warrant to purchase 51,443.83 shares of common stock of the Issuer at an exercise price of $10.00 per share, (iv) cash in lieu of fractional shares, and (v) the Reporting Person's pro rata portion, if any, of the holdback shares of common stock of the Issuer (such pro rata portion of the holdback shares would, without offset, initially be equal to 173,751.48 shares of common stock of the Issuer). /s/ Thomas S. Lam 2022-12-07