0001493152-21-032038.txt : 20211220
0001493152-21-032038.hdr.sgml : 20211220
20211220161540
ACCESSION NUMBER: 0001493152-21-032038
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211220
FILED AS OF DATE: 20211220
DATE AS OF CHANGE: 20211220
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Rachman Ilya M
CENTRAL INDEX KEY: 0001889334
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41159
FILM NUMBER: 211505435
MAIL ADDRESS:
STREET 1: 11400 WEST OLYMPIC BLVD.,
STREET 2: SUITE 200
CITY: LOS ANGELES
STATE: CA
ZIP: 90064
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Immix Biopharma, Inc.
CENTRAL INDEX KEY: 0001873835
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 454869378
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 11400 WEST OLYMPIC BLVD.
STREET 2: SUITE 200
CITY: LOS ANGELES
STATE: CA
ZIP: 90064
BUSINESS PHONE: (888) 958-1084
MAIL ADDRESS:
STREET 1: 10573 W. PICO BLVD.
STREET 2: #58
CITY: LOS ANGELES
STATE: CA
ZIP: 90064
4
1
ownership.xml
X0306
4
2021-12-20
0
0001873835
Immix Biopharma, Inc.
IMMX
0001889334
Rachman Ilya M
C/O IMMIX BIOPHARMA, INC.
11400 WEST OLYMPIC BLVD., SUITE 200
LOS ANGELES
CA
90064
1
1
0
0
CEO and Chairman
Common Stock
2021-12-20
4
P
0
2500
5.00
A
902500
D
/s/ Ilya Rachman
2021-12-20