Individual
MARCELLA R. BOTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3030 CHILDRENS WAY, SUITE 402, SAN DIEGO, CA 92123-4232
(858) 309-7701
(858) 966-8038
Mailing address
3860 CALLE FORTUNADA, STE #210, SAN DIEGO, CA 92123-4802
(858) 309-6303
(858) 309-6301
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
G87904
CA
207YP0228X
Pediatric Otolaryngology Physician
Primary
G87904
CA
Other
Enumeration date
05/27/2006
Last updated
11/16/2011
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