Individual ProviderMarcella R. BothwellOtolaryngologyAllopathic & Osteopathic PhysiciansPractice Address3030 Childrens Way, Suite 402, San Diego, CA 92123-4232(858) 309-7701(858) 309-6303PECOS EnrollmentBased on the most recent information from CMS, provider Marcella R. Bothwell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1962459982Provider TypeIndividualFull NameBothwell, Marcella R.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date5/27/2006Last Updated11/16/2011Contact InformationPractice LocationPractice Address3030 Childrens Way, Suite 402, San Diego, CA 92123-4232Phone(858) 309-7701Fax(858) 966-8038Mailing LocationMailing Address3860 Calle Fortunada, Ste #210, San Diego, CA 92123-4802Phone(858) 309-6303Fax(858) 309-6301Provider TaxonomiesCodeDescriptionLicenseCode207YP0228XPrimaryDescriptionOtolaryngologyAllopathic & Osteopathic PhysiciansLicenseG87904CaliforniaCode207Y00000XDescriptionOtolaryngologyAllopathic & Osteopathic PhysiciansLicenseG87904California